Endocrinol Metab.  2011 Sep;26(3):253-257. 10.3803/EnM.2011.26.3.253.

A Case of Primary Adrenal Insufficiency in a Patient with Acquired Immunodeficiency Syndrome

Affiliations
  • 1Department of Endocrinology and Metabolism, College of Medicine, Kyung Hee University, Seoul, Korea. jik1016@khu.ac.kr
  • 2Department of Infection, College of Medicine, Kyung Hee University, Seoul, Korea.

Abstract

The adrenal gland is the most commonly involved endocrine organ in patients infected with the human immunodeficiency virus (HIV). Adrenal function abnormality is more common in HIV patients than in the general population. It is important to recognize the condition of adrenal insufficiency, as this adrenal disorder may prove fatal if left untreated. Herein, we report a case of primary adrenal insufficiency in a 37-year-old male patient with acquired immunodeficiency syndrome. The patient complained of fever, general weakness, and fatigue. Impaired adrenal function was noted in the rapid ACTH stimulation test. After steroid supplementation, the patient's symptoms were improved. Therefore, HIV care physicians should ascertain adrenal dysfunction in HIV patients when they complain of fever and general weakness.

Keyword

Adrenal insufficiency; Cortisol; Human immunodeficiency virus

MeSH Terms

Acquired Immunodeficiency Syndrome
Addison Disease
Adrenal Glands
Adrenal Insufficiency
Adrenocorticotropic Hormone
Adult
Fatigue
Fever
HIV
Humans
Hydrocortisone
Male
Adrenocorticotropic Hormone
Hydrocortisone

Figure

  • Fig. 1 Abdominal CT scan showed normal contour of right (A, C) and left (B, C) adrenal glands (arrows).

  • Fig. 2 The results of rapid ACTH stimulation test before and after cortisol replacement therapy. A. Cortisol response after ACTH stimulation was abnormal because the peak cortisol level was less than 18 µg/mL. B. The increased gap of aldosterone after ACTH stimulation was less than 50 pg/mL which suggested decreased response of aldosterone.


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