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Endocrinogonadic implications in male uro-genital tuberculosis.

Unlike females, the endocrine gonadic syndrome in males usually accompanies the disorders of the excreting apparatus. Interpretation of the lesions as uro-genital tuberculosis has been commonly accepted in practice. Researches carried out in males, much fewer than in females, have showed a number of particular aspects of the syndrome. This paper makes a brief survey of these aspects based on updated references.

Epididymis↗

[Effects of low-intensity laser irradiation on hormonal responsiveness of patients with pulmonary tuberculosis].

To examine the impact of low-intensive laser radiation (LILR) on endocrine function in patients with pulmonary tuberculosis, the time course of blood levels of thyroid hormones, cortisol, and insulin was studied in 117 patients of whom 64 received complex treatment by using LILR. Pulmonary tuberculosis was ascertained to be characterized by a marked hormonal imbalance, including impaired metabolism of thyroid hormones, hypercorticism, altered pancreatic incretion, which negatively affects the efficiency of antituberculosis therapy. Intravenous and epicutaneous therapy promotes recovery of endocrine responsiveness and enhances the efficiency of treatment in patients with pulmonary tuberculosis.

Antitubercular Agents↗

T cell helper types and endocrines in the regulation of tissue-damaging mechanisms in tuberculosis.

The necrotising immunopathology, which is accompanied by very little mycobactericidal activity, is probably the key to the pathogenesis of tuberculosis. Conventional chemotherapy fails to correct this immunoregulatory anomaly, so the host response does little to assist the drugs in the removal of the "persister" subpopulation of bacteria. Therefore chemotherapy must be prolonged for at least 6 months, with consequent problems of cost, resistance, and compliance. If we can learn to switch off the necrotising pathway, and replace it with bactericidal mechanisms, treatment of the disease will be enormously improved and shortened. One problem is that we do not know the mechanism of cell-mediated immunity to tuberculosis in man. On the other hand, we are gaining some insights into the mechanism of the necrosis, and there are encouraging indications that it can indeed be separated from immunity, and that it can be suppressed by suitable immunotherapy. We present here some evidence that when a TH2 response is superimposed upon a pre-existing TH1 response, the resulting cell-mediated inflammatory site becomes exquisitely sensitive to cytokine-mediated damage. There is clear evidence for a TH2 component in the immune response of tuberculosis patients. This inappropriate TH1 to TH2 shift may result from subtle endocrinological changes brought about by M. tuberculosis and the response to it. Immunotherapy should aim to switch off this TH2 component.

Adrenal Glands↗

[Endocrine disorders and principles of their correction in patients with pulmonary tuberculosis and concomitant diabetes mellitus].

The performance of the insular system of the pancreatic gland was studied in 111 pulmonary tuberculosis patients who suffered from diabetes mellitus as were the functions of thyroid and pituitary-adrenal glands assessed by the blood content of C-peptide, T3, T4, TTH, ACTH and circadian excretion of 17-OCS. It was stated that the combined pathology was accompanied with pronounced endocrine disorders, pancreatic incretory function was found to be depended both on the pattern and severity of diabetes mellitus course and clinical manifestations of pulmonary tuberculosis. In combined disease high frequency of absolute and relative insufficiency of hypophyseal adrenocortical performance and adrenal glucocorticoid performance occurs. Revealed disorders were found to be depended on the clinical patterns of pulmonary tuberculosis and the type of diabetes mellitus as well as on the duration and severity of the course of both conditions. Combined pathology was frequently (60%) accompanied with the development of hypothyrosis manifested by the reduction of T3 content in the blood serum, imbalance of thyroid hormones (elevation of T4 to T3 ratio). The disorders mentioned were mostly manifest in patients with severe course of the combined pathology. Hypothyrosis aggravated a therapeutic prognosis for tuberculosis in diabetic patients. The treatment of both conditions performed with regard to the character of endocrine disorders was of great aid in reaching the improvement in the course of pulmonary tuberculosis in 92.8%.

Adolescent↗