Addison's disease due to tuberculous adrenalitis

Abstract

Addison's disease is defined as an inability of the adrenal gland to produce steroids in sufficient quantities (primary adrenal insufficiency). Tuberculosis is still the main cause of Addison's disease in developing countries. Most of the patients with adrenal tuberculosis are asymptomatic, and in those patients with symptoms, the clinical picture is nonspecific. The diagnostic approach includes measurement of morning serum cortisol levels (decreased), adrenocorticotropic hormone (elevated), characteristic findings on imaging studies, and sometimes adrenal biopsy. Regarding treatment, in addition to steroid replacement, hypovolemia and hyponatremia should be treated with adequate fluid replacement. Specific therapy against Mycobacterium tuberculosis should also be initiated. In this article, a clinical case of Addison’s disease due to tuberculous adrenalitis is reported.