Korean J Med.
2016 Apr;90(4):351-356. 10.3904/kjm.2016.90.4.351.
Addison Disease Due to Adrenal Tuberculosis Presenting as an Abscess in a Nearby Psoas Muscle with a Duodenal Fistula
- Affiliations
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- 1Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea.
- 2Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Paul's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea. sangah@catholic.ac.kr
- KMID: 2268851
- DOI: http://doi.org/10.3904/kjm.2016.90.4.351
Abstract
- An 80-year-old male with nausea and poor oral intake was referred for evaluation of hyponatremia. Primary adrenal insufficiency was diagnosed by a rapid adrenocorticotropic hormone (ACTH) stimulation test. The cause of the adrenal insufficiency was revealed to be adrenal tuberculosis presenting as a bilateral adrenal mass on computed tomography imaging. During the first few months of treatment, the size of the tuberculous mass increased and spread to an adjacent area, and further adrenal hormone replacement was needed. In addition, there was a newly developed tuberculous abscess in a nearby psoas muscle with a duodenal fistula. Thus, we report a case of a long-term clinical course of Addison's disease with changes in hormone replacement as a result of active adrenal tuberculosis, together with a review of the literature.
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