Primary Adrenal Tuberculosis: A Case Report
Keywords:
Primary adrenal tuberculosisAbstract
Tuberculosis (TB) is a world-wide epidemic. The World Health Organization estimated a global incidence of around 10 million new cases in 2019, and it is one of the top 10 causes of death in the world with 1.2 million deaths annually. Tuberculosis is mainly a pulmonary disease, and extra-pulmonary tuberculosis accounts for 5% to 15% of all cases. Primary adrenal tuberculosis is rare, constituting 6% of all TB cases. We report a case of primary adrenal tuberculosis, with a discussion of the clinical features, radiologic and pathological findings and treatment outcomes. A review of the current knowledge of this disease is also provided.
References
Global tuberculosis report 2019. World Health Organization. Geneva, 2019.
Lam K Y, Lo C Y. A critical examination of adrenal tuberculosis and a 28-year autopsy experience of active tuberculosis. Clin Endocrinol 2001;54;633–9.
Nakaoka K, Branch J, Yamaguchi M, et al. A case of primary adrenal tuberculosis - a diagnostic quandary. Endocrinol Metabol Syndrome 2012;1:1;doi:10.4172/2161-1017.1000103.
Del Borgo C, Urigo C, Morocco R, et al. Diagnostic and therapeutic approach in a rare case of primary bilateral adrenal tuberculosis. J Med Microbiol 2010;59: 1527-9.
Lomte N, Bandgar T, Khare S, et al. Bilateral adrenal masses: a single- centre experience. Endocr Connect 2016;5:92-100.
Rajasekharan C, Ajithkumar S, Anto V, Parvathy R. Extrapulmonary disseminated tuberculosis with tuberculous adrenalitis: a stitch in time saves nine. BMJ Case Rep 2013;2013:bcr2012008011.doi: 10.1136/bcr-2012-008011.
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; 2014:876037.doi:10.1155/2014/876037.
Wang YX, Chen CR, He GX, et al. CT findings of adrenal glands in patients with tuberculous Addison’s disease. J Belge Radiol 1998;81:226–8.
Fassnacht M, Arlt W, Bancos I, et al. Management of adrenal incidentalomas: European Society of Endocrinology Clinical Practice Guideline in collaboration with the European Network for the Study of Adrenal Tumors. Eur J Endocrinol 2016;175:G1-G34.
Zhang Y, Doerfler M, Lee TC, et al. Mechanisms of stimulation of interleukin-1 beta and tumor necrosis factor-alpha by mycobacterium tuberculosis components. J Clin Invest 1993; 91:2076-83.
Kelestimur F. The endocrinology of adrenal tuberculosis: The effects of tuberculosis on the hypothalamo-pituitary-adrenal axis and adrenocortical function. J Endocrinol Invest 2004;27:380-86.
Nieman L K, Biller B M K, Findling J W, et al. The diagnosis of cushing’s syndrome: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab 2008;93:1526–40.
Melmed S, Polonsky K S, Larsen P R, Kronenberg. Williams textbook of endocrinology. Philadelphia, PA: Elsevier; 2016:109-75.
Lee JY. Diagnosis and treatment of extrapulmonary tuberculosis. Tuberc Respir Dis (Seoul) 2015;78:47-55.
Paolo WF, Jr., Nosanchuk JD. Adrenal infections. Int J Infect Dis. 2006;10:343-53.
Kox LFF, Rhienthong D, Miranda AM, et al. A more reliable PCR for detection of Mycobacterium tuberculosis in clinical samples. J Clin Microbiol 1994;32:672-8.
Theron G, Peter J, Calligaro G, et al. Determinants of PCR performance (Xpert MTB/RIF), including bacterial load and inhibition, for TB diagnosis using specimens from different body compartments. Sci Rep 2014;4:5658.doi:10.1038/srep05658.
Nahid P, Dorman SE, Alipanah N, et al. Official American Thoracic Society/Centers for Disease Control and Prevention/Infectious Diseases Society of America Clinical Practice Guidelines: treatment of drug-susceptible tuberculosis. Clin Infect Dis 2016;63:e147-e95.
Bhatia E, Jain SK, Gupta RK, Pandey R. Tuberculous Addison’s disease: lack of normalization of adrenocortical function after anti-tuberculous chemotherapy. Clin Endocrinol 1998;48:355-9.
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