rifampin and Thyroid-Diseases

Thyroid tuberculosis is rare. In the last decade, however, the incidence of extrapulmonary forms of tuberculosis has increased. We report on 2 cases of thyroid tuberculosis. In case 1, a tubercular abscess mimicking acute thyroiditis was found which was correctly diagnosed by fine-needle aspiration biopsy (FNAb). No evidence of active disease was noticed. Pleural thickening on chest X-ray was the only sign compatible with a previous infection. In case 2, tubercular thyroiditis with lymph node enlargement was also diagnosed by FNAb in a reevaluation setting. In both cases treatment with antitubercular drugs resulted in complete recovery. Thyroid tuberculosis should be kept in mind in the differential diagnosis of thyroid nodules, notably in patients with a history of tuberculous disease. FNAb represents the main approach to making the diagnosis.

Topics: Abscess; Aged; Aged, 80 and over; Antitubercular Agents; Biopsy, Needle; Ethambutol; Female; Humans; Isoniazid; Lymph Nodes; Mycobacterium tuberculosis; Rifampin; Thyroid Diseases; Tuberculosis, Endocrine

Glucocorticoids are used in physiological and pharmacological amounts in the management of a variety of clinical conditions. Concomitant utilisation of other drugs or the presence of some diseases may affect the physiological action of the steroid in the tissues. Phenytoin, phenobarbitone, ephedrine and rifampicin accelerate the metabolism of glucocorticoids thereby decreasing their biological activity. A similar phenomenon occurs in patients with hyperthyroidism. In contrast, glucocorticoid action is enhanced in hypothyroid patients and in those with hepatic damage as the result of a defect in the clearance of the hormone from blood. In turn, glucocorticoids antagonise the effects of cholinesterase inhibitors and ganglion blocking agents. The above mentioned effects should be kept in mind whenever glucocorticoids are utilised in the diagnosis and management of endocrine or non-endocrine conditions.

Topics: Anticonvulsants; Cholinesterase Inhibitors; Contraceptives, Oral; Cushing Syndrome; Dexamethasone; Diuretics; Drug Interactions; Ephedrine; Ganglionic Blockers; Glucocorticoids; Humans; Hypnotics and Sedatives; Insulin; Kinetics; Liver Diseases; Pancuronium; Rifampin; Salicylates; Thyroid Diseases