J Korean Soc Endocrinol.  1994 Sep;9(3):239-243.

A Case of True Precocious Puberty Associated with Pituitary Microadenoma Treated with LHRH Agonist

• Kim HJ
• Kim IS
• Ahn YH
• Kim MH
• Lee JU
• Kim JH
• Park IS
• Yoon HJ
• Kee CS
• Park SS
• Lee JH

Abstract

Although tubercrlosis is one of the recognized causes of adrenal insufficiency, little is known about adrenal function in patients with active pulmonary tuberculosis. Patients with active pulmonary tuberculosis are at risk from sudden and unexpected death which can occur during the first few weeks of treatment. There are many reports that patients who received rifampicin as a part of their treatment appeared to show impairment in adrenocortical function when compared to a group who received anti-tuberculosis chemotherapy which did not include rifampicin. Adrenocortical function was studied in 15 patients(7 males, 8 females) with active pulmonary tuberculosis, before and 2-weeks after the anti-tuberculosis chemotherapy including rifampicin. At 08: 00 hour a base-line sample of venous blood was taken. One hour after the administration of 0.25mg of Synacthen, a further blood specimen was taken. The base-line and 1-hour specimens were analysed for plasma cortisol and electrolytes.All were initially found to have a normal cortisol response to rapid ACTH stimulation test. Following a 2-week course of anti-tuberculosis chemotherapy including rifampicin there was 1 case(6.6%) of a suboptimal response.Rifampicin, a powerful anti-tuberculosis drug, is a known inducer of the hepatic microsomal enzyme system and has been shown to cause an enhanced clearance of endogenous cortisol. Findings reported in this paper suggest that the adrenocortical function is compromised in some case(6.6%) of tuberculosis patients. It will therefore be necessary to undertake detailed investigations on the effect of treatment with daily and fully intermittent regimens containing rifampicin on the function of this endocrine gland.

MeSH Terms

Adrenal Insufficiency
Adrenocorticotropic Hormone
Drug Therapy
Endocrine Glands
Gonadotropin-Releasing Hormone*
Humans
Hydrocortisone
Male
Plasma
Puberty, Precocious*
Rifampin
Tuberculosis
Tuberculosis, Pulmonary
Adrenocorticotropic Hormone
Gonadotropin-Releasing Hormone
Hydrocortisone
Rifampin