Acute adrenal insufficiency as the primary manifestation of extrapulmonary tuberculosis: A case report

Author: Herman Trianto ¹ ; Nurria Betty ¹ ; Laksmi Sasiarini ¹ ; Rulli Rosandi ¹ ; Putu Arsana ¹ ; Djoko Soeatmadji ¹ ; Achmad Rudijanto ¹
Author Information

1. Endocrinology, Metabolic Disease and Diabetes Division, Internal Medicine Department Brawijaya University - Saiful Anwar General Hospital, Malang, Indonesia
Publication Type:Case Reports
Keywords: Acute adrenal insufficiency; Serum cortisol; Urinary symptoms
MeSH: Addison Disease; Tuberculosis
From: Journal of the ASEAN Federation of Endocrine Societies 2016;31(1):59-64
CountryPhilippines
Language:English
Abstract: Acute adrenal insufficiency (AI) is a life-threatening condition. While Addison’s disease (AD) is rare, in developing countries, tuberculosis (TB) still remains as the primary cause in 7 to 20% of cases. Urinary TB is also the third most common form of extrapulmonary disease. We report a case of 37-year-old male who presented with weakness, anorexia, weight loss, dysuria, flank pain and low grade fever. Examination revealed hypotension, hyperpigmentation, hyponatremia, hypoglycemia and low serum cortisol. He was diagnosed to have adrenal crisis due to Addison’s disease and extrapulmonary TB manifesting as urinary tract infection (UTI). He was treated with corticosteroids and anti-TB medications. Urologic reconstructive surgery was subsequently planned.
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