CHANGES IN THE SIZE OF ADRENAL-GLANDS IN ACUTE PULMONARY TUBERCULOSISWITH THERAPY

Adrenal glands may be involved during both acute and chronic tuberculo sis. They are enlarged in acute pulmonary tuberculosis. We aimed to in vestigate the changes in adrenal size in acute pulmonary tuberculosis before and after therapy in a prospective study. Eleven hospitalized p atients with newly diagnosed sputum positive pulmonary tuberculosis we re studied. Basal cortisol levels were measured in the patients before and after the therapy. Cortisol levels were also measured 30 and 60 m in after Synacthen (250 mu g i.v.) injection in the patients before th e therapy. The size of the adrenal glands was measured by computerized tomography. The maximum width perpendicular to the long axis of the b ody of the gland, maximum width of the medial and lateral limbs and th e length of the adrenals were measured. All measurements were done bef ore and after the eight-month anti-tuberculosis therapy. All 11 patien ts had an intact adrenal cortisol reserve. Both the width and length o f the right and left adrenal glands were significantly greater before the therapy than after the therapy. We conclude that adrenal enlargeme nt demonstrated by computerized tomography in acute pulmonary tubercul osis is reduced after appropriate therapy.