scholarly journals Adrenal Tuberculosis Leading to Acute Adrenal Insufficiency

2021 ◽  
Vol 11 (6) ◽  
pp. 148-151
Author(s):  
Nitu Sharma ◽  
Yashika Bhatia
Keyword(s):  
Case Report ◽  
Infectious Diseases ◽  
Adrenal Insufficiency ◽  
Acute Gastroenteritis ◽  
Primary Infection ◽  
Unusual Case ◽  
Primary Adrenal Insufficiency ◽  
Death Case ◽  
Acute Adrenal Insufficiency ◽  
Adrenal Deficiency

Background: Tuberculosis is the ‘world’s largest killer’ amongst infectious diseases overtaking HIV in 2014. Tuberculosis can affect the kidneys and adrenals as either primary infection or secondary dissemination from other organs. Tuberculosis in adrenals manifests in the acute phase leading to primary adrenal insufficiency, which is generally catastrophic leading to death. Case Report: We present an unusual case of a 42 years’ old man, presented & managed as a case of acute gastroenteritis. Patient had a fulminant course and succumbed to his illness. Autopsy revealed Bilateral Adrenal Tuberculosis. Conclusion: Adrenal tuberculosis has the potential of causing acute adrenal deficiency leading to Addisonian crisis and consequent mortality. Key words: Adrenal tuberculosis, Addisonian crisis, acute adrenal insufficiency.

scholarly journals Primary adrenal insufficiency due to bilateral adrenal infarction in COVID-19: a case report

2021 ◽  
Author(s):  
Iza F R Machado ◽  
Isabel Q Menezes ◽  
Sabrina R Figueiredo ◽  
Fernando Morbeck Almeida Coelho ◽  
Debora R B Terrabuio ◽  
...  
Keyword(s):  
Case Report ◽  
Adrenal Insufficiency ◽  
Antiphospholipid Syndrome ◽  
Antiphospholipid Antibodies ◽  
Case Reports ◽  
Serum Cortisol ◽  
Primary Adrenal Insufficiency ◽  
Acute Adrenal Insufficiency ◽  
Adrenal Infarction ◽  
New Onset

Abstract Context Coronavirus disease 2019 (COVID-19) is a proinflammatory and prothrombotic condition, but its impact on adrenal function has not been adequately evaluated. Case report A 46-year-old woman presented with abdominal pain, hypotension, skin hyperpigmentation after COVID-19 infection. The patient had hyponatremia, serum cortisol <1.0 ug/dL, ACTH of 807 pg/mL and aldosterone <3 ng/dL. Computed tomography (CT) findings of adrenal enlargement with no parenchymal and minimal peripheral capsular enhancement after contrast were consistent with bilateral adrenal infarction. The patient had autoimmune hepatitis and positive antiphospholipid antibodies, but no previous thrombotic events. The patient was treated with intravenous hydrocortisone, followed by oral hydrocortisone and fludrocortisone. Discussion Among 115 articles, we identified nine articles, including case reports, of new-onset adrenal insufficiency and/or adrenal hemorrhage/infarction on CT in COVID-19. Adrenal insufficiency was hormonally diagnosed in five cases, but ACTH levels were measured in only three cases (high in one case and normal/low in other two cases). Bilateral adrenal non- or hemorrhagic infarction was identified in five reports (two had adrenal insufficiency, two had normal cortisol levels and one case had no data). Interestingly, the only case with well-characterized new-onset acute primary adrenal insufficiency after COVID-19 had a previous diagnosis of antiphospholipid syndrome. In our case, antiphospholipid syndrome diagnosis was established only after the adrenal infarction triggered by COVID-19. Conclusions Our findings support the association between bilateral adrenal infarction and antiphospholipid syndrome triggered by COVID-19. Therefore, patients with positive antiphospholipid antibodies should be closely monitored for symptoms or signs of acute adrenal insufficiency during COVID-19.

Addison’s Disease Presenting with Abdominal Pain

2006 ◽  
Vol 5 (3) ◽  
pp. 102-103
Author(s):  
Tejal Desai ◽  
◽  
Tristan Richardson ◽  
Keyword(s):  
Quality Of Life ◽  
Abdominal Pain ◽  
Life Expectancy ◽  
Adrenal Insufficiency ◽  
Unusual Case ◽  
Primary Adrenal Insufficiency ◽  
Prompt Treatment ◽  
Bilateral Destruction ◽  
Important Disease

Primary Adrenal Insufficiency is due to bilateral destruction of the adrenal cortex and has a prevalence of approximately 40-60 per million adults. 1 The commonest cause is autoimmune. 1 Prompt treatment not only restores quality of life but also a normal life expectancy. 2 Here we present an unusual case of primary adrenal insufficiency, which illustrates how such an important disease often provides a diagnostic conundrum.

scholarly journals Treatment of gynecomastia with prednisone: case report and literature review

2019 ◽  
Vol 47 (5) ◽  
pp. 2288-2295 ◽  
Author(s):  
Yansheng Jin ◽  
Maoxiao Fan
Keyword(s):  
Adrenal Insufficiency ◽  
Serum Cortisol ◽  
Underlying Disease ◽  
Left Breast ◽  
Serum Cortisol Level ◽  
Unique Case ◽  
Primary Adrenal Insufficiency ◽  
Adrenal Deficiency ◽  
Laboratory Investigations ◽  
The Brain

This study aimed to report a unique case of primary adrenal insufficiency that was accompanied by painful gynecomastia, which was resolved by treatment with prednisone. Enlargement of the left breast with continuous weakness and generalized nausea in a male was discovered 3 months before admission. Magnetic resonance imaging of the brain was normal 1 month before presentation. A physical examination revealed that the diameter of the left breast was 5 cm and the height was 3 cm. Laboratory investigations revealed hyponatremia, with a low serum cortisol level and an elevated prolactin level. Hyperprolactinemia was suspected because of adrenal deficiency that was directly or indirectly associated with increased prolactin levels. Thus, a diagnosis of hyperprolactinemia was confirmed. Ultrasonography of the left breast showed glandular tissue hyperplasia. In the present study, treating adrenal insufficiency with prednisone relieved both gynecomastia and hyponatremia. However, gynecomastia regression and hyponatremia resolution were observed when prednisone was stopped. Gynecomastia completely resolved by re-administering prednisone. Therefore, treating the underlying disease is essential so that prednisone can be given in a timely manner.

scholarly journals Obojestranska krvavitev v nadledvičnico: vzrok visoki zgodnji zlatenici in akutni primarni insuficienci nadledvičnic pri novorojenčku

2018 ◽  
Vol 87 (3-4) ◽  
Author(s):  
Petja Fister ◽  
Marta Žnidaršič Eržen ◽  
Primož Kotnik ◽  
Mojca Tomažič
Keyword(s):  
Gestational Diabetes ◽  
Adrenal Insufficiency ◽  
Clinical Case ◽  
Adrenal Glands ◽  
Clinical Signs ◽  
Term Neonate ◽  
Primary Adrenal Insufficiency ◽  
Acute Adrenal Insufficiency ◽  
Life Threatening ◽  
Threatening Situation

Adrenal bleeding in a newborn is rare. The cause of bleeding is unknown, most likely due to several factors. Bleeding may be minimal with no clinical signs or fulminant with acute adrenal insufficiency, which is a life-threatening situation that requires immediate detection and treatment.In this paper we represent a clinical case of a term neonate born to the mother with gestational diabetes, who was hospitalised due to high early hyperbilirubinemia. Significant bleeding in both adrenal glands was identified by ultrasound and primary adrenal insufficiency diagnosed. We discuss possible causes, the diagnostic clues, the treatment of disease and its prognosis.

Primary adrenal insufficiency secondary to COVID-19 infection: A case report

2020 ◽  
Author(s):  
Porras Mariana Gomes ◽  
Moreno Rosa García ◽  
Larrauri Myriam Zapatero ◽  
Rojas Patricia Martin ◽  
Ramírez Paola Parra
Keyword(s):  
Case Report ◽  
Adrenal Insufficiency ◽  
Primary Adrenal Insufficiency

scholarly journals Premature Mortality in Patients with Addison’s Disease: A Population-Based Study

2006 ◽  
Vol 91 (12) ◽  
pp. 4849-4853 ◽  
Author(s):  
Ragnhildur Bergthorsdottir ◽  
Maria Leonsson-Zachrisson ◽  
Anders Odén ◽  
Gudmundur Johannsson
Keyword(s):  
Survival Rate ◽  
Confidence Interval ◽  
Infectious Diseases ◽  
Adrenal Insufficiency ◽  
Addison’S Disease ◽  
Population Based ◽  
Addison's Disease ◽  
Primary Adrenal Insufficiency ◽  
Background Population

Abstract Background: The survival rate of patients with primary adrenal insufficiency (Addison’s disease) undergoing currently accepted replacement therapy is not known, although well-informed patients are considered to have a normal survival rate. In this study, we evaluated the mortality of patients with Addison’s disease in Sweden. Methods: A population-based, retrospective, observational study was performed, using the National Swedish Hospital and Cause of Death Registers, covering the period from 1987–2001. After a diagnosis of Addison’s disease, each patient was followed until the end of follow-up or death. Mortality was compared with that of the Swedish background population. Findings: We identified 1675 patients (995 women and 680 men) diagnosed with primary adrenal insufficiency. The average follow-up from initial diagnosis was 6.5 yr. Five hundred seven patients died during the study period compared with an expected 199. The risk ratio for all-cause mortality was 2.19 (confidence interval 1.91–2.51) for men and 2.86 (confidence interval 2.54–3.20) for women. The excess mortality in both men and women was attributed to cardiovascular, malignant, and infectious diseases. Concomitant diabetes mellitus was observed in 12% of the patients, but only contributed to the increased mortality to a minor extent. Interpretation: Compared with the background population, we observed that the risk ratio for death was more than 2-fold higher in patients with Addison’s disease. Cardiovascular, malignant, and infectious diseases were responsible for the higher mortality rate.

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