title: Thyroid profile status of patients treated for multidrug-resistant tuberculosis in state of Meghalaya, India.
abstract: BACKGROUND
  Meghalaya has high tuberculosis burden with increasing multidrug-resistant tuberculosis (MDR-TB) cases. Drug-induced hypothyroidism is one of the well-documented adverse effects in treatment of MDR-TB, the data of which are unavailable in the population residing in this part of the Indian subcontinent.
  
  
  OBJECTIVE
  This study was undertaken to assess the thyroid profile status of patients under DOTS Plus treatment and to evaluate the effects of anti-tubercular drugs on thyroid functions with respect to the pre-treatment thyroid status.
  
  
  METHODS
  A prospective study of 114 patients who initiated treatment for MDR-TB between June 2012 and August 2013 was performed. Thyroid hormones, viz., TSH, Total T3, Total T4, Free T3 and Free T4 were estimated.
  
  
  RESULTS
  Out of our study group of 114 MDR-TB patients, 15 dead patients and defaulters were excluded. So, out of 99 patients, till now, 76 patients have completed 6 months of DOTS Plus treatment and were re-evaluated for thyroid status. 52(68%) patients showed TSH levels more than the reference limit of 5.60 μIU/mL and 5(7%) patients had TSH >10 μIU/mL suggesting presence of sub-clinical hypothyroidism.
  
  
  CONCLUSIONS
  We suggest the need for Mandatory TSH screening at baseline and then six months interval for all patients taking DOTS Plus so that no adverse effect goes under-reported and early intervention if required should be done to maintain proper adherence.
authors.affiliation: Senior Resident, Department of Biochemistry, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh 160012, India. Electronic address: gsaharia@yahoo.com.
authors.forename: Gautom Kumar
authors.initials: GK
authors.lastname: Saharia
authors.affiliation: Associate Professor, Department of Biochemistry, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong, Meghalaya, 793018, India.
authors.forename: Alice Abraham
authors.initials: AA
authors.lastname: Ruram
authors.affiliation: District Tuberculosis Officer, District TB Centre, East Khasi Hills District, Jhalupara, Shillong, 793002, India.
authors.forename: Joyantimon
authors.initials: J
authors.lastname: Lyngwa
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use*; D002648:Child; D023801:Directly Observed Therapy; D005260:Female; D006801:Humans; D007194:India; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013963:Thyroid Hormones / Q000097:blood*; D018088:Tuberculosis, Multidrug-Resistant / Q000097:blood* / Q000188:drug therapy*; D055815:Young Adult
chemical_list: D000995:Antitubercular Agents; D013963:Thyroid Hormones
keywords: Hypothyroidism; Meghalaya; Multidrug-resistant tuberculosis (MDR-TB), DOTS Plus