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Acute adrenal crisis together with unilateral adrenal mass caused by isolated tuberculosis of adrenal gland. Endocrine practice : official journal of the American College of Endocrinology and the American Association of Clinical Endocrinologists. [Endocr Pract] Journal article

 
TitleAcute adrenal crisis together with unilateral adrenal mass caused by isolated tuberculosis of adrenal gland.
Author(s)Serter R, Koç G, Demirbas B, Culha C, Ongören AU, Ustün H, Aral Y 
InstitutionDepartment of Endocrinology and Metabolism, Ankara Training and Research Hospital of The Ministry of Health, Ankara, Turkey.
SourceEndocr Pract 2003 Mar-Apr; 9(2):157-61.
MeSHAcute Disease
Adrenal Insufficiency
Giant Cells, Langhans
Histiocytes
Hormones
Humans
Male
Middle Aged
Necrosis
Tomography, X-Ray Computed
Tuberculosis, Endocrine
AbstractOBJECTIVE: To describe a patient admitted with acute adrenocortical failure and a right adrenal mass without evidence of tuberculosis, who was ultimately diagnosed with isolated adrenal tuberculosis after postoperative histopathologic evaluation.
METHODS: A case report is presented, with clinical, laboratory, and imaging findings. We also discuss potential factors that may complicate the diagnosis of tuberculosis.
RESULTS: A 61-year-old man was admitted with symptoms and signs of acute adrenal crisis. The patient had an erythrocyte sedimentation rate of 30 mm in 1 hour, a negative tuberculin skin test, a 6-cm right adrenal mass, and left adrenal nodularity in conjunction with normal findings on a computed tomographic scan of the chest. He recovered dramatically after intravenous corticosteroid treatment. Investigation, including acid-fast staining and cultures for tuberculosis of all available specimens, gastroduodenoscopy and rectosigmoidoscopy, intestinal x-ray imaging, and autoantibody studies, did not disclose the diagnosis. Subsequently, bilateral adrenalectomy revealed isolated tuberculosis of the adrenal glands on histopathologic evaluation. Quadruple antituberculous therapy was initiated, and continued follow-up of the patient is scheduled.
CONCLUSION: Our case indicates that acute or chronic adrenocortical failure can occur as a result of tuberculosis of the adrenal gland, despite the absence of clinical and laboratory evidence of tuberculosis.
Languageeng
Pub Type(s)Case Reports
Journal Article
PubMed ID12917080
  
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