Endocrine Complications of Tuberculosis
Summary
Tuberculosis can extend beyond the lungs to involve key endocrine organs, leading to a spectrum of hormonal disturbances. Granulomatous infiltration of the adrenal glands is a classic cause of primary adrenal insufficiency, manifesting as fatigue, hyperpigmentation and hypotension. Involvement of the hypothalamic–pituitary axis may follow tuberculous meningitis or the formation of pituitary tuberculomas, resulting in hypopituitarism and variable deficiencies of cortisol, thyroid and gonadal hormones. Dysregulation of antidiuretic hormone secretion, either through central nervous system invasion or ectopic production, produces hyponatraemia and the syndrome of inappropriate antidiuretic hormone secretion. Thyroid involvement is rare but can mimic nodular goitre or Graves’ disease, delaying diagnosis. Such endocrine complications carry significant morbidity and may be overlooked in regions where tuberculosis remains endemic. Prompt recognition, supported by biochemical evaluation and imaging, is crucial to initiate hormone replacement alongside antituberculous therapy and to avoid potentially fatal endocrine crises.
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Endocrine Complications of Tuberculosis publication trend
The graph below shows the total number of articles in endocrine complications of tuberculosis across all publications each year (not limited to Nature Index journals).
Technical terms
Adrenal insufficiency: Failure of adrenal glands to produce sufficient cortisol, often due to granulomatous destruction.
Hypopituitarism: Reduced secretion of one or more pituitary hormones following infection of the pituitary gland or its stalk.
Hyponatraemia: Serum sodium concentration below normal, occurring when antidiuretic hormone is inappropriately elevated.
SIADH: Syndrome of inappropriate antidiuretic hormone secretion, causing water retention and dilutional hyponatraemia.
Extrapulmonary tuberculosis: Infection by Mycobacterium tuberculosis in organs other than the lungs, including endocrine glands.
Tuberculoma: Localised granulomatous mass formed by tuberculosis in the central nervous system or other tissues.
References
- Associations of hyponatremia and SIADH with increased mortality, young age and infection parameters in patients with tuberculosis. PLOS ONE (2022).
- Pituitary Hormone Involvement in Tuberculous Meningitis. Afro-Egyptian Journal of Infectious and Endemic Diseases (2023).
- Incidental Finding of Thyroid Tuberculosis by Operation for Graves’ Disease: A Rare Case Presentation. Case Reports in Endocrinology (2024).
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