A hormonal and radiological evaluation of adrenal gland in patients with acute or chronic pulmonary tuberculosis.
OBJECTIVE
The adrenal glands may be involved in tuberculosis. The exact frequency and extent of adrenal involvement in tuberculosis are not well known. Although there are some studies regarding adrenal gland involvement, they are not sufficient because of inadequate endocrinological tests and radiological procedures. The aim of this study was to assess the adrenal gland in acute and chronic pulmonary tuberculosis and to compare it with the findings obtained in healthy subjects.


METHODS
We studied 20 patients with acute pulmonary tuberculosis, 41 patients with chronic pulmonary tuberculosis and 20 healthy subjects. Involvement of the adrenal gland was assessed by basal cortisol level, cortisol response to Synacthen and adrenal computed tomography.


METHODS
Cortisol levels were measured before, 30 and 60 minutes after Synacthen (250 micrograms i.v.) injection. Computerized tomography of the adrenals was carried out in 61 patients with tuberculosis and 20 healthy subjects.


RESULTS
Mean basal cortisol level and 60-minute cortisol response to Synacthen were significantly higher in acute pulmonary tuberculosis than in chronic pulmonary tuberculosis and healthy subjects. Two patients with Addison's disease were diagnosed among the chronic tuberculous patients. Both length and thickness of the right and left adrenal gland were greater in patients with acute tuberculosis.


CONCLUSIONS
Adrenal enlargement demonstrated by computerized tomography is common in patients with acute pulmonary tuberculosis, but our findings show that cortisol reserve is normal, in contrast to previous suggestions.
Keleştimur
F
F
Department of Internal Medicine, Erciyes University, Medical School, Kayseri, Turkey.
Unlü
Y
Y
Ozesmi
M
M
Tolu
I
I
D000208:Acute Disease; D000293:Adolescent; D000311:Adrenal Glands / Q000000981:diagnostic imaging / Q000503:physiopathology*; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D003366:Cosyntropin; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed; D014397:Tuberculosis, Pulmonary / Q000097:blood / Q000000981:diagnostic imaging / Q000503:physiopathology*
D003366:Cosyntropin; C006418:adrenocorticotropin zinc; D006854:Hydrocortisone