Primary Adrenal Tuberculosis Causing Adrenal Insufficiency

Maller, VV; Afzal, M. Omer; S, Vijay Shankar

doi:10.12809/hkjr1615361

Cited by 3 publications

(7 citation statements)

References 0 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…European studies have shown autoimmunity to be the cause of PAI in 44.5%–94% of these patients while TB and other aetiologies amounting to up to a third of cases 3–5 8. Apart from TB, histoplasmosis, blastomycosis and various human immunodeficiency-related infections are other rare causes of infectious adrenal enlargement in the west 9 10…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Tuberculosis as a differential for bilateral adrenal masses in the UK

et al. 2019

View full text Add to dashboard Cite

Primary adrenal insufficiency (PAI) is a potentially fatal disease. Adrenal tuberculosis(TB) causing PAI is rare in the developed world. We present a seemingly well, 78-year-old Caucasianwoman in the UK who developed adrenal crisis following elective hip surgery. Biochemical tests confirmed PAI and steroid replacement was initiated. Imaging of the abdomen demonstrated bilateral adrenal masses and a fluorodeoxyglucose positron emission tomography (FDG-PET) scan showed increased uptake in both adrenals suggestive of malignancy. Following a retroperitoneoscopic left adrenalectomy, histology showed caseating necrosis with xanthogranulomatous inflammation favouring a diagnosis of TB. She was commenced on anti-TB treatment. Diagnosing adrenal TB in the west can be challenging especially in the absence of extra-adrenal TB. FDG-PET scans can be falsely positive in presence of chronic active inflammatory conditions, such as TB, and a tissue diagnosis is required. It is important that clinicians remain vigilant of this important disease, which can masquerade as malignancy.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Several cases have been reported in the western world in the recent past 28–30. Del Borgo et al reported a patient with prolonged febrile illness and bilateral adrenal masses diagnosed with acute tuberculous adrenalitis successfully treated with anti-TB medication.…”

Section: Discussionmentioning

confidence: 99%

Tuberculosis as a differential for bilateral adrenal masses in the UK

et al. 2019

View full text Add to dashboard Cite

show abstract

“…Addison's disease merupakan manifestasi klinis dari rendahnya produksi atau aktivitas glukokortikoid, dengan atau tanpa disertai defisiensi mineralokortikoid. 1,2,3 Manifestasi klinis utama dari insufisiensi adrenal meliputi adanya kelemahan (weakness), kelelahan, anoreksia, nyeri perut, penurunan berat badan, hipotensi ortostatik, dan hiperpigmentasi pada kulit. 1…”

Section: Laporan Kasusunclassified

Tuberculous Addison’s Disease

Efendi

Decroli²

2019

JKA

View full text Add to dashboard Cite

Tuberculous addison’s disease merupakan insufisiensi adrenal primer akibat infeksi tuberkulosis pada kelenjar adrenal. Manifestasi klinisnya meliputi kelemahan, kelelahan, anoreksia, penurunan berat badan, hipotensi ortostatik, dan hiperpigmentasi kulit. Tuberkulosis adalah penyebab yang paling utama di negara berkembang. Dilaporkan seorang wanita dua puluh delapan tahun dengan keluhan kulit seluruh tubuh semakin menghitam disertai bercak-bercak kehitaman pada lidah, dan seringkali merasa lemah, letih, lesu. Riwayat penyakit dahulu: TB paru satu setengah tahun yang lalu. Pemeriksaan fisik: nadi enam puluh tujuh kali per menit, tekanan darah 100/60 mmmHg, hiperpigmentasi pada kulit, bibir, kuku, dan lidah. Laboratorium disimpulkan hiperadrenokortitropin dan hipokortisolisme. CT Scan adrenal: pembesaran kelenjar adrenal bilateral disertai kalsifikasi multipel, sugestif tuberkulosis. Pasien didiagnosis insufisiensi adrenal primer akibat tuberkulosis. Terapi yang diberikan metilprednisolon 1x6 mg. Pada pasien terjadi perbaikan klinis dan parameter laboratoris. Hiperpigmentasi, lemah, letih, lesu, dan anoreksia ditemukan pada sebagian besar pasien addison’s disease. Untuk penelusuran penyebab insufisiensi adrenal primer, dilakukan CT Scan adrenal. Gambaran khas TB adrenal pada CT Scan adalah berupa pembesaran kelenjar adrenal, kalsifikasi dengan central low attenuation, dan peripheral enhancement. Terapi adalah terapi substitusi yang merupakan lifelong hormone therapy.

show abstract

“…First Addison's disease (AD) or primary adrenocortical insufficiency by Thomas Addison in patients with adrenal tuberculosis (adrenal TB). 2 , 3 , 5 Currently in developed countries, about 75–80% of AD cases are caused by autoimmune destruction, ie autoimmune adrenalitis, whereas tuberculosis and other cases is the cause for 7–20% cases. TB still be a major cause of Addison in developing countries.…”

mentioning

confidence: 99%

“…CT or MR features of adrenal TB are enlarged bilateral masses, peripheral rim enhancement and calcification. 4 , 5 …”

mentioning

confidence: 99%

A case report: Addison disease caused by adrenal tuberculosis

Soedarso

Nugroho

Dewi

2018

Urology Case Reports

View full text Add to dashboard Cite

We report middle age man with skin hyperpigmentation oral and lip mucous membranes, general malaise and depression. Further examinations lead to adrenal insufficiency, Addison's disease. Imaging studies show bilateral adrenal hyperplasia, show negative result for tuberculosis.We perform laparoscopic adrenalectomy. Multiple caseosa necrosis in gross specimen and Langhan's giant cells microscopic appearance ensure patient suffered Addison's disease cause by adrenal gland tuberculosis.

show abstract

Primary Adrenal Tuberculosis Causing Adrenal Insufficiency

Cited by 3 publications

References 0 publications

Tuberculosis as a differential for bilateral adrenal masses in the UK

Tuberculosis as a differential for bilateral adrenal masses in the UK

Tuberculous Addison’s Disease

A case report: Addison disease caused by adrenal tuberculosis

Contact Info

Product

Resources

About