The effect of individual chemotherapy regimens on thyroid homeostasis in patients with multidrug resistant tuberculosis

Abstract

Objective — to determine the side effects of some second-line drugs used in the treatment of MRTB on thyroid function.Materials and methods. In 120 patients with multidrug-resistant tuberculosis who received individual regimens with the inclusion of thioamides (ethionamide or prothionamide) together with para-amino salicylic acid (PAS), thyroid homeostasis was investigated before the start of treatment, at the end of the intensive phase and after the end of treatment. We studied both echostructure of the thyroid gland and its function. The echo structure of the thyroid gland was studied with the help of the SSF-240a diagnostic ultrasound device manufactured by Toshiba Medical Systems (Japan). Indicators of thyroid function: levels of free thyroxine (Т4) and thyroid-stimulating hormone (TSH) were studied by immunobio­chemical method.Results and discussion. The results obtained demonstrated the inhibitory effect of anti-tuberculosis drugs on the hormonal function of the thyroid gland of patients with multidrug-resistant tuberculosis. Of the 120 patients, 30 % developed clinical hypothyroidism, which was diagnosed by increasing the level of TSH and reducing the level of free Т4. In 4 patients (12.12 %) a goiter developed with a decrease in the level of free Т4, on average, to (6.11 ± 1.32) pmol/l and an increase in the level of TSH, on average, to (11.0 ± 1.43) µIU/mL).Conclusions. A decrease in thyroid function during anti-tuberculosis chemotherapy using thioamides simultaneously with PAS has been proven. The monitoring of thyroid function using the definition of TSH for its correction during chemotherapy of multidrug resistant tuberculosis with the marked regimens was proposed.