The well authenticated observation of the sharp increase in the adult form of tuberculosis in the girl at puberty, with the similar incidence in the boy maturing a few years later, has constantly been related in the minds of workers in that field to the possibility that an alteration in metabolism at this period might play a role in the activation of a hitherto latent lesion, and it has made desirable more information on the nutritional requirement in this seemingly critical age period. It was my own confirmation of this phenomenon in the course of a ten year follow-up of tuberculin reactors to detect the onset of the adult type lesion that led me to this study. Nineteen of the 29 patients with the adult type of tuberculosis detected in this survey were girls, and of these, 16 had contracted it between the ages of 11 and 17.
JOHNSTON JA. FACTORS INFLUENCING RETENTION OF NITROGEN AND CALCIUM IN PERIOD OF GROWTH: III. PUBERTY IN THE NORMAL GIRL AND IN THE GIRL WITH THE MINIMAL REINFECTION TYPE OF TUBERCULOSIS. Am J Dis Child. 1940;59(2):287–309. doi:10.1001/archpedi.1940.01990130070005
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