Summary:
Tuberculosis may affect many of the endocrine glands
including the hypothalamus, pituitary, thyroid with adrenal
gland being the commonest. We describe a patient presented
with recurrent spontaneous hypoglycemia, hypotension,
fever, weight loss and cough. Along with this clinical picture,
high ACTH in the face of low cortisol was compatible with
diagnosis of Addison’s disease. Rapid ACTH stimulation
test affirmed the diagnosis. Disseminated TB affecting
adrenal glands was supported by CXR, USG, CT Abdomen
and FNAC. Adrenal Crisis was led by add-on bacterial
pneumonia. Patient made good recovery with treatment for
adrenal crisis and subsequently with standard antitubercular
regimen and steroid replacement therapy.
Tuberculosis, although uncommon but potentially
devastating cause of adrenal failure, merits consideration
when fever, weight loss, gastrointestinal symptoms,
hyponatremia, hyperkalemia are observed in patients with
features of active tuberculosis or past history of tuberculosis.
Key words: Addison’s disease (AD), Tuberculosis (TB).
(J Banagladesh Coll Phys Surg 2015; 33: 44-47)