Study of adrenal function in patients with tuberculosis

Unilateral adrenal tuberculosis whose computed tomography imaging characteristics mimic a malignant tumor: A case report

“…Firstly, rifampicin increases cortisol catabolism while isoniazid produces increased levels of cortisol via an opposite effect on the enzyme activity 6-Bhydroxylase; secondly, hepatitis, induced by isoniazid and worsened by rifampicin, leads to failure of 11-B-oxo-reductase, which converts cortisone to cortisol; and finally, tuberculous Addison’s disease might require increased amounts of hydrocortisone due to rifampicin administration[ 23 ]. Up to 70% of patients with active TB have subclinical adrenal insufficiency[ 24 ]. Anti-TB treatment might cause adrenal crisis[ 18 ], and patients should be closely monitored when starting this treatment.…”

An autopsy case of unexpected death due to Addison’s disease caused by adrenal tuberculosis

“…As a result, the diagnosis is frequently delayed, resulting in a clinical presentation with an acute life-threatening adrenal crisis [ 8 ]. Majority cases of adrenal insufficiency (AD) in the developed countries are attributed to autoimmune adrenalitis in contrast to the developing countries where tuberculosis is implicated to be the most common cause of adrenal insufficiency [ 7 , 9 ]. In 2019, tuberculosis remained the most common cause of death from a single infectious pathogen [ 10 ].…”

“…The diagnosis is therefore often delayed. The fact that adrenal insufficiency may result not only in poor general condition of the patient, but also death due to adrenal crisis makes it all the more important to address this issue seriously [ 7 ]. Evidence on clinical presentation and evaluation of patients with adrenal insufficiency caused by bilateral adrenal tuberculosis is scarce.…”

An Autopsy Case of Sudden Death Due To Adrenal Crisis Caused By Pulmonary Tuberculosis Complicated With Adrenal Tuberculosis

“…As a result, the diagnosis is frequently delayed, resulting in a clinical presentation with an acute lifethreatening adrenal crisis [6]. Majority cases of adrenal insu ciency in the developed countries are attributed to autoimmune adrenalitis in contrast to the developing countries where tuberculosis is implicated to be the most common cause of adrenal insu ciency [5,7].In 2019, tuberculosis remained the most common cause of death from a single infectious pathogen [8].In China, although the incidence of tuberculosis has decreased in recent years, the country still shares a signi cant part of the global burden of tuberculosis cases (8.4 %) [8].People living in rural areas, those who were less educated showed a low level of awareness of key knowledge about tuberculosis, leading to a delay in seeking care [9]. Adrenal insu ciency which may be caused by adrenal tuberculosis is a severe and potentially life-threatening condition related to the central role of glucocorticoids and/or mineralocorticoids in energy, salt, and uid homeostasis [10].Laboratory value of the patient in this case showed signi cant reduction of cortisol and incredible increase of adrenocorticotropic hormone.…”

“…The diagnosis is therefore often delayed. The fact that adrenal insu ciency may result not only in poor general condition of the patient but also sudden death due to adrenal crisis, makes it all the more important to address this issue seriously [5]. Evidence on clinical presentation and evaluation of patients with adrenal insu ciency caused by bilateral adrenal tuberculosis is scarce.…”