Keywords
Mycobacterium tuberculosis
Tuberculosis
Adrenal Insufficiency
Tuberculosis
Adrenal Insufficiency
How to Cite
Pérez, M. A., Naranjo Millán, J., Millán, H. A., Luna Vela, F. A., & Flórez, A. (2018). Adrenal tuberculosis in an immunocompetent patient: a case report. Revista Colombiana De Endocrinología, Diabetes &Amp; Metabolismo, 5(3), 45–48. https://doi.org/10.53853/encr.5.3.435
Abstract
In the first half of the 20th century Tuberculosis infection was the first cause of adrenal insufficiency, now displaced by primary autoimmune insufficiency; however, in developing countries Tuberculosis Adrenalitis remains one of the etiologies to be considered. We present the case of a 53-year-old man with changes in hyperpigmentation, asthenia and adynamia prior to respiratory symptoms, initially diagnosed pulmonary tuberculosis and under treatment with Isoniazid, Rifampicin, Ethambutol and Pirazinamide presented signs of adrenal crisis.
References
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2. Ordóñez Sánchez SA, López Osma FA. Tuberculosis en Colombia, de la historia al entendimiento de la enfermedad. Tuberc Colomb from Hist to Underst Dis [Internet]. 2013;16(3):127-42.
3. INS. Protocolo De Vigilancia En Salud Publica Tuberculosis. Inst Nac Salud [Internet]. 2016;42. Available from: http://www.ins.gov.co:81/lineas-de-accion/Subdireccion-Vigilancia/sivigila/Protocolos SIVIGILA/PRO Tuberculosis.pdf
4. Bensing S, Hulting A, Husebye ES, Kämpe O, Løvås K. Epidemiology , Qualty of Life and Complications of Primary Adrenal Insufficiency?: a review . 2016;(April):1-27.
5. Charmandari E, Nicolaides NC, Chrousos GP. Adrenal insufficiency. Lancet. 2014;383(9935):2152-67.
6. Shah M, Reed C. Complications of tuberculosis. Curr Opin Infect Dis [Internet]. 2014;27(5):403-10. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25028786
7. Pearce JMS. Thomas Addison (1793-1860). J R Soc Med. 2004 Jun;97(6):297- 300.
8. Upadhyay J, Sudhindra P, Abraham G, Trivedi N. Tuberculosis of the adrenal gland: A case report and review of the literature of infections of the adrenal gland. Int J Endocrinol. 2014;2014.
9. Ray A, Suri JC, Gupta M. Case Report Rifampicin induced adrenal crisis in an uncommon setting. 2013;30(4):1-2.
10. Denny N, Raghunath S, Bhatia P, Abdelaziz M. Rifampicin-induced adrenal crisis in a patient with tuberculosis?: a therapeutic challenge. 2016;
11. Wilkins EG, Hnizdo E, Cope A. Addisonian crisis induced by treatment with rifampicin. Tubercle. 1989 Mar;70(1):69-73.
12. Kelestimur F. The endocrinology of adrenal tuberculosis: the effects of tuberculosis on the hypothalamo-pituitary-adrenal axis and adrenocortical function. J Endocrinol Invest. 2004 Apr;27(4):380-6.
13. Fukata J, Imura H, Nakao K. Cytokines as mediators in the regulation of the hypothalamic-pituitary-adrenocortical function. J Endocrinol Invest. 1994 Feb;17(2):141-55.
14. Pozzoli G, Costa A, Grimaldi M, Schettini G, Preziosi P, Grossman A, et al. Lipopolysaccharide modulation of eicosanoid and corticotrophin-releasing hormone release from rat hypothalamic explants and astrocyte cultures in vitro: evidence for the involvement of prostaglandin E2 but not prostaglan- din F2 alpha and lack of effect of nerve growth factor. J Endocrinol. 1994 Jan;140(1):103-9.
15. Bongiovanni B, Ariana D, Attilio LD, Santucci N, Griselda D, Lioi S, et al. Changes in the immune and endocrine responses of patients with pulmonary tuberculosis undergoing specific treatment. 2012;1262:10-5.
16. Baker RW, Walker BR, Shaw RJ, Honour JW, Jessop DS, Lightman SL, et al. Increased Cortisol Cortisone Ratio in Acute Pulmonary Tuberculosis. 2000;
17. Laway BA, Khan I, Shah BA, Choh NA, Bhat MA, Shah ZA. Pattern of adrenal morphology and function in pulmonary tuberculosis: Response to treatment with antitubercular therapy. Clin Endocrinol (Oxf ). 2013;79(3):321-5.
18. Guo YK, Yang ZG, Li Y, Ma E Sen, Deng YP, Min PQ, et al. Addison’s disease due to adrenal tuberculosis: Contrast-enhanced CT features and clinical duration correlation. Eur J Radiol. 2007;62(1):126-31.
19. Chakera AJ, Vaidya B. Addison Disease in Adults: Diagnosis and Management. Am J Med [Internet]. 2010;123(5):409-13. Available from: http:// dx.doi.org/10.1016/j.amjmed.2009.12.017
20. Bornstein SR, Allolio B, Arlt W, Barthel A, Don-wauchope A, Hammer GD, et al. Diagnosis and Treatment of Primary Adrenal Insufficiency?: An Endocrine Society Clinical Practice Guideline. 2016;(January):1-26.
21. Practice E. Amir H Hamrahia, Maria Fleseriu. AACE Adrenal Scientific Committee. 2017.
22. Manso MC, Rodeia SC, Rodrigues S, Domingos R. Synchronous presentation of two rare forms of extrapulmonary tuberculosis. BMJ Case Rep. 2016 Apr;2016:10.1136/bcr-2015-212917.
23. Rajasekharan C, Ajithkumar S, Anto V, Parvathy R. Extrapulmonary disseminated tuberculosis with tuberculous adrenalitis: a stitch in time saves nine. BMJ Case Rep. 2013 May;2013.
24. Sharma M, Patil A, Somani P. Bilateral adrenal tuberculosis diagnosed by endoscopic ultrasound-guided fine-needle aspiration cytology. Endoscopy. 2016;48 Suppl 1:E246-7.
25. Ikoma A, Namai K, Saito T, Kawano T, Saito T, Kasono K, et al. Unilateral active adrenal tuberculosis featuring persistent intermittent fever. Endocr J. 2004 Oct;51(5):463-6.
26. Imisairi AH, Hisham AN. Adrenal tuberculosis: The atypical presentations of eggshell-like calcifications. ANZ J Surg. 2009;79(6):488-9.
27. Gómez Rodríguez S, Pavón de Paz I, Torán Ranero CE, Modroño Móstoles N, Pérez Blanco C. Afecciones de ayer y hoy. Enfermedad de Addison de causa tuberculosa. Semer - Med Fam [Internet]. 2016;42(6):416– 8. Available from: http://linkinghub.elsevier.com/retrieve/pii/S1138359315002750
2. Ordóñez Sánchez SA, López Osma FA. Tuberculosis en Colombia, de la historia al entendimiento de la enfermedad. Tuberc Colomb from Hist to Underst Dis [Internet]. 2013;16(3):127-42.
3. INS. Protocolo De Vigilancia En Salud Publica Tuberculosis. Inst Nac Salud [Internet]. 2016;42. Available from: http://www.ins.gov.co:81/lineas-de-accion/Subdireccion-Vigilancia/sivigila/Protocolos SIVIGILA/PRO Tuberculosis.pdf
4. Bensing S, Hulting A, Husebye ES, Kämpe O, Løvås K. Epidemiology , Qualty of Life and Complications of Primary Adrenal Insufficiency?: a review . 2016;(April):1-27.
5. Charmandari E, Nicolaides NC, Chrousos GP. Adrenal insufficiency. Lancet. 2014;383(9935):2152-67.
6. Shah M, Reed C. Complications of tuberculosis. Curr Opin Infect Dis [Internet]. 2014;27(5):403-10. Available from: http://www.ncbi.nlm.nih.gov/pubmed/25028786
7. Pearce JMS. Thomas Addison (1793-1860). J R Soc Med. 2004 Jun;97(6):297- 300.
8. Upadhyay J, Sudhindra P, Abraham G, Trivedi N. Tuberculosis of the adrenal gland: A case report and review of the literature of infections of the adrenal gland. Int J Endocrinol. 2014;2014.
9. Ray A, Suri JC, Gupta M. Case Report Rifampicin induced adrenal crisis in an uncommon setting. 2013;30(4):1-2.
10. Denny N, Raghunath S, Bhatia P, Abdelaziz M. Rifampicin-induced adrenal crisis in a patient with tuberculosis?: a therapeutic challenge. 2016;
11. Wilkins EG, Hnizdo E, Cope A. Addisonian crisis induced by treatment with rifampicin. Tubercle. 1989 Mar;70(1):69-73.
12. Kelestimur F. The endocrinology of adrenal tuberculosis: the effects of tuberculosis on the hypothalamo-pituitary-adrenal axis and adrenocortical function. J Endocrinol Invest. 2004 Apr;27(4):380-6.
13. Fukata J, Imura H, Nakao K. Cytokines as mediators in the regulation of the hypothalamic-pituitary-adrenocortical function. J Endocrinol Invest. 1994 Feb;17(2):141-55.
14. Pozzoli G, Costa A, Grimaldi M, Schettini G, Preziosi P, Grossman A, et al. Lipopolysaccharide modulation of eicosanoid and corticotrophin-releasing hormone release from rat hypothalamic explants and astrocyte cultures in vitro: evidence for the involvement of prostaglandin E2 but not prostaglan- din F2 alpha and lack of effect of nerve growth factor. J Endocrinol. 1994 Jan;140(1):103-9.
15. Bongiovanni B, Ariana D, Attilio LD, Santucci N, Griselda D, Lioi S, et al. Changes in the immune and endocrine responses of patients with pulmonary tuberculosis undergoing specific treatment. 2012;1262:10-5.
16. Baker RW, Walker BR, Shaw RJ, Honour JW, Jessop DS, Lightman SL, et al. Increased Cortisol Cortisone Ratio in Acute Pulmonary Tuberculosis. 2000;
17. Laway BA, Khan I, Shah BA, Choh NA, Bhat MA, Shah ZA. Pattern of adrenal morphology and function in pulmonary tuberculosis: Response to treatment with antitubercular therapy. Clin Endocrinol (Oxf ). 2013;79(3):321-5.
18. Guo YK, Yang ZG, Li Y, Ma E Sen, Deng YP, Min PQ, et al. Addison’s disease due to adrenal tuberculosis: Contrast-enhanced CT features and clinical duration correlation. Eur J Radiol. 2007;62(1):126-31.
19. Chakera AJ, Vaidya B. Addison Disease in Adults: Diagnosis and Management. Am J Med [Internet]. 2010;123(5):409-13. Available from: http:// dx.doi.org/10.1016/j.amjmed.2009.12.017
20. Bornstein SR, Allolio B, Arlt W, Barthel A, Don-wauchope A, Hammer GD, et al. Diagnosis and Treatment of Primary Adrenal Insufficiency?: An Endocrine Society Clinical Practice Guideline. 2016;(January):1-26.
21. Practice E. Amir H Hamrahia, Maria Fleseriu. AACE Adrenal Scientific Committee. 2017.
22. Manso MC, Rodeia SC, Rodrigues S, Domingos R. Synchronous presentation of two rare forms of extrapulmonary tuberculosis. BMJ Case Rep. 2016 Apr;2016:10.1136/bcr-2015-212917.
23. Rajasekharan C, Ajithkumar S, Anto V, Parvathy R. Extrapulmonary disseminated tuberculosis with tuberculous adrenalitis: a stitch in time saves nine. BMJ Case Rep. 2013 May;2013.
24. Sharma M, Patil A, Somani P. Bilateral adrenal tuberculosis diagnosed by endoscopic ultrasound-guided fine-needle aspiration cytology. Endoscopy. 2016;48 Suppl 1:E246-7.
25. Ikoma A, Namai K, Saito T, Kawano T, Saito T, Kasono K, et al. Unilateral active adrenal tuberculosis featuring persistent intermittent fever. Endocr J. 2004 Oct;51(5):463-6.
26. Imisairi AH, Hisham AN. Adrenal tuberculosis: The atypical presentations of eggshell-like calcifications. ANZ J Surg. 2009;79(6):488-9.
27. Gómez Rodríguez S, Pavón de Paz I, Torán Ranero CE, Modroño Móstoles N, Pérez Blanco C. Afecciones de ayer y hoy. Enfermedad de Addison de causa tuberculosa. Semer - Med Fam [Internet]. 2016;42(6):416– 8. Available from: http://linkinghub.elsevier.com/retrieve/pii/S1138359315002750
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