Partners In Health Lesotho, Maseru, Lesotho.
Int J Tuberc Lung Dis. 2012 Apr;16(4):468-72. doi: 10.5588/ijtld.11.0615.
Hypothyroidism is a known side effect of treatment for multidrug-resistant tuberculosis (MDR-TB), but it is considered to be rare. Hypothyroidism has vague and non-specific symptoms, and can be easily missed by clinicians.
To report the high rate of hypothyroidism in a cohort of MDR-TB patients in Lesotho and to describe our approach to diagnosis and management.
A retrospective study of 212 patients who initiated treatment for MDR-TB in Lesotho between 27 July 2007 and 24 March 2009 was performed.
Among 186 patients screened, 129 (69%) had hypothyroidism, defined as at least one documented thyroid-stimulating hormone (TSH) result > 10.0 mIU/l; 100 (54%) patients had a maximum TSH > 20.0 mIU/l. At 93 days after starting MDR-TB treatment, half of the patients had developed hypothyroidism.
Hypothyroidism may be more common during MDR-TB treatment than previously recognized. Screening all patients, even those without symptoms, for hypothyroidism within 2-3 months of starting MDR-TB treatment should be considered until prospective studies can inform screening guidelines.
甲状腺功能减退症是治疗耐多药结核病（MDR-TB）的已知副作用，但它被认为很少见。甲状腺功能减退症的症状模糊且非特异性，容易被临床医生忽视。
报告莱索托 MDR-TB 患者队列中甲状腺功能减退症的高发生率，并描述我们的诊断和管理方法。
对 2007 年 7 月 27 日至 2009 年 3 月 24 日期间在莱索托开始接受 MDR-TB 治疗的 212 例患者进行回顾性研究。
在筛查的 186 例患者中，有 129 例（69%）患有甲状腺功能减退症，定义为至少有一份记录的促甲状腺激素（TSH）结果>10.0 mIU/l；100 例（54%）患者的最大 TSH > 20.0 mIU/l。在开始 MDR-TB 治疗后 93 天，一半的患者出现了甲状腺功能减退症。
在 MDR-TB 治疗期间，甲状腺功能减退症的发生可能比以前认识到的更为常见。在开始 MDR-TB 治疗后 2-3 个月内，应考虑对所有患者（即使无症状）进行甲状腺功能减退症筛查，直到前瞻性研究能够为筛查指南提供信息。
