Palabras clave
Mycobacterium tuberculosis
tuberculosis
enfermedad de Addison
insuficiencia adrenal
tuberculosis
enfermedad de Addison
insuficiencia adrenal
Cómo citar
Pérez, M. A., Naranjo Millán, J., Millán, H. A., Luna Vela, F. A., & Flórez, A. (2018). Tuberculosis adrenal en un paciente inmunocompetente: reporte de un caso. Revista Colombiana De Endocrinología, Diabetes &Amp; Metabolismo, 5(3), 45–48. https://doi.org/10.53853/encr.5.3.435
Resumen
En la primera mitad del siglo XX, la infección por tuberculosis era la primera causa de insuficiencia suprarrenal, ahora desplazada por la insuficiencia suprarrenal autoinmune primaria; sin embargo, en países en desarrollo la adrenalitis por tuberculosis sigue siendo una de las etiologías más frecuentes(1). Presentamos el caso de un hombre de 53 años con cambios de hiperpigmentación generalizada, astenia y adinamia previo al inicio de los síntomas respiratorios. Se realizó el diagnóstico de tuberculosis pulmonar y durante el tratamiento con isoniacida, rifampicina, etambutol y pirazinamida presentó crisis suprarrenal.
Citas
1. Agarwal G, Bhatia E, Pandey R, Jain SK. Clinical profile and prognosis of Addison’s disease in India. Natl Med J India. 2001;14(1):23-5.
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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