Global patterns and clinical outcomes of endocrine gland involvement in tuberculosis: A comprehensive mini-review
Notice bibliographique
Résumé
Background: Tuberculosis (TB) remains a significant global health challenge, particularly in low- and middle-income countries where extrapulmonary forms—including endocrine gland involvement—often go unrecognized. Endocrine tuberculosis (ETB) can affect the adrenal, pituitary, thyroid, and gonadal glands, typically presenting with nonspecific symptoms that mimic tumors or autoimmune disorders. Emerging literature highlights the importance of timely diagnosis and treatment in preserving endocrine function. Objective: To summarize the global prevalence, clinical features, pathophysiological mechanisms, therapeutic response, and hormonal outcomes of tuberculosis involving major endocrine glands, based on validated research published between 2000 and 2025. Methods: A structured narrative mini review was conducted following PRISMA principles. Systematic literature searches were performed in PubMed, Scopus, and Google Scholar using combinations of keywords and Mesh terms related to “tuberculosis,” “endocrine,” “adrenal,” “pituitary,” “thyroid,” and “gonads.” Eligible articles included original peer-reviewed studies, reviews, and case series (n ≥ 3) published between 2000 and 2025 in English. Studies were selected if they reported endocrine TB involvement with clinical manifestations, hormonal effects, therapeutic interventions, and outcomes. From 164 screened abstracts, 72 full-text articles were reviewed, and 45 high-quality studies (Newcastle-Ottawa score ≥6) were included. Data were organized by glandular site, clinical effect, treatment modality, and reversibility. Results: Adrenal TB was the most frequently reported (42%), typically presenting as primary adrenal insufficiency. Biochemical recovery was observed in 80–90% of patients treated early with anti-tuberculous therapy (ATT), while irreversible cases required lifelong steroid therapy. Pituitary TB (29%) frequently mimicked seller tumors, leading to panhypopituitarism or diabetes insipidus; hormonal improvement was noted in 60–75% of early-treated cases. Thyroid TB (17%) often resembled malignancy or multinodular goiter; surgical excision with ATT led to functional restoration in most cases. Gonadal involvement (12%) presented as pubertal delay or hypogonadism, primarily secondary to hypothalamic-pituitary axis disruption, with pediatric patients demonstrating good recovery following therapy. Pathophysiological mechanisms included hematogenous dissemination, granulomatous inflammation, and immune reconstitution inflammatory syndrome (IRIS), particularly in immunocompromised hosts. Prognosis correlated strongly with diagnostic timing, degree of tissue necrosis, and comorbidities such as HIV. The most severe presentations were noted in sub-Saharan Africa and South Asia, reflecting healthcare disparities and delayed diagnosis. Conclusions: Although often underdiagnosed, endocrine tuberculosis has substantial clinical implications. Adrenal and pituitary glands are most commonly involved. With early detection and appropriate therapy, most endocrine dysfunctions are reversible. Enhanced awareness, interdisciplinary care, and long-term follow-up are vital for improving outcomes, especially in TB-endemic regions.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,003 | 0,013 |
| Méta-épidémiologie (sens strict) | 0,001 | 0,001 |
| Méta-épidémiologie (sens large) | 0,004 | 0,004 |
| Bibliométrie | 0,014 | 0,012 |
| Études des sciences et des technologies | 0,000 | 0,001 |
| Communication savante | 0,002 | 0,003 |
| Science ouverte | 0,001 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,003 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».