From the Guidelines
Yes, ovarian tuberculosis can cause loss of appetite, as it is a form of extrapulmonary tuberculosis that can lead to systemic symptoms, including constitutional symptoms like fatigue, weight loss, low-grade fever, and decreased appetite 1. Ovarian TB is typically caused by Mycobacterium tuberculosis spreading through the bloodstream or lymphatic system from a primary site, usually the lungs. The infection triggers an inflammatory response that releases cytokines and other immune mediators that can affect the hypothalamus, which regulates hunger.
Some key points to consider in the management of ovarian TB include:
- The disease can affect all the genitourinary organs and is almost always secondary to the haematogenous spread of chronic latent TB infection (LTBI) 1.
- Diagnosis of genitourinary TB is challenging owing to the lack of a single diagnostic test, and relies on a high index of suspicion according to patient history, along with microbiological, molecular, and histological testing, as well as imaging findings 1.
- Patients with ovarian TB may present with non-specific symptoms, including menstrual irregularities and pelvic pain, in addition to systemic symptoms like loss of appetite 1.
- Treatment for ovarian TB requires a standard anti-tuberculosis regimen, and maintaining adequate nutrition during treatment is crucial to support recovery 1.
It is essential to note that treatment for ovarian TB should follow the standard anti-tuberculosis regimen, consisting of isoniazid, rifampin, ethambutol, and pyrazinamide for 2 months, followed by isoniazid and rifampin for an additional 4 months, for a total of 6 months of therapy 1. As treatment progresses and the infection is controlled, appetite typically improves. Patients should maintain adequate nutrition during treatment to support recovery, and healthcare providers should monitor for medication side effects, which can sometimes also affect appetite.
From the Research
Ovarian Tuberculosis and Loss of Appetite
- Ovarian tuberculosis (TB) is a rare entity with non-specific clinical manifestations, including constitutional symptoms such as anorexia, weight loss, night sweats, and evening rise in temperature, which have been reported in up to 45% of patients 2.
- The symptoms of ovarian TB can be similar to those of other conditions, making diagnosis challenging, and loss of appetite (anorexia) is one of the common symptoms associated with TB 2, 3.
- A study on pulmonary tuberculosis and tuberculous pleurisy complicated with rifampicin-induced hypothyroidism reported a case where the patient experienced persistent appetite loss, which was improved after treatment for hypothyroidism 4.
- Another study hypothesized that chronic lack of appetite can be a cause of malnutrition associated with TB and therefore a potential independent risk factor for latent tuberculosis infection (LTBI) or TB disease 3.
- Isolated ovarian tuberculosis can mimic ovarian carcinoma, leading to diagnostic difficulties, and symptoms such as weight loss and elevated CA-125 levels can be present 5.
- Genital tuberculosis, including ovarian TB, can present with variable clinical presentations, including weight loss and loss of appetite, especially in postmenopausal women 6.