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Tuberculosis of the Adrenal Glands

Tuberculosis of Adrenal Glands Unspecified Examination


Presentation

  • This enhanced eBook experience allows you to search all of the text, figures, and references on a variety of devices, as well as access interactive online case presentations for effective exam review.[books.google.com]
  • The most common symptoms are non-specific and diagnosis is therefore often delayed and patients may first present with a life-threatening crisis.[jpccr.eu]
  • ‘There is no disease’, wrote Sir Zachary, ‘other than Addison’s disease that could present a face that was “black and white” and at the same time give rise to the other symptoms described in her letters.’[healthdoctrine.com]
  • We present a case report of a middleaged male with histopathologically proven tuberculosis with Addison's disease.[uthsc.pure.elsevier.com]
  • Case presentation A 37-year-old male soldier presented in 1997 with classical Addison's disease. He presented with fatigue, nausea, vomiting, weight loss, malaise and dizziness.[edmcasereports.com]
Chronic Cough
  • The classic symptoms of active TB are a chronic cough with blood-tinged sputum, fever, night sweats, and weight loss. This weight loss was what gave rise to the old term "consumption" for the disease.[icd.codes]

Workup

  • Addison Disease workup at eMedicine Further reading [ edit ] Bornstein, SR; Allolio, B; Arlt, W; Barthel, A; Don-Wauchope, A; Hammer, GD; Husebye, ES; Merke, DP; Murad, MH; Stratakis, CA; Torpy, DJ (February 2016).[en.wikipedia.org]
Pericardial Effusion
  • effusion that may develop into constrictive pericarditis, often with calcifications Bones Commonly in the vertebral column ( 50% ) tuberculous spondylitis ( Pott disease ) ; see vertebral osteomyelitis Imaging: osteolysis Meninges ( tuberculous meningitis[amboss.com]

Treatment

  • Treatment may also include taking a medication that helps restore the body's level of sodium and potassium.[stanfordchildrens.org]
  • […] in first-line treatment: Rifampin, Isoniazid, Pyrazinamide, and Ethambutol.[amboss.com]
  • Hydrocortisone dose was therefore completely withdrawn and the patient remains well after 4 months of treatment. After treatment, his 0900 h ACTH level was initially elevated at 86 ng/l but has now normalised at 13 ng/l.[edmcasereports.com]
  • Every Addisonian should wear an identification bracelet stating that he or she has the disease, to insure proper emergency treatment. An identification card outlining treatment is also suggested.[nadf.us]
  • […] it can be punctate, localized, or diffuse gland density: central low density can be seen in early disease due to caseous necrosis with anti-TB treatment the adrenals show homogenous density enhancement: can see areas of relative central hypoenhancement[radiopaedia.org]

Prognosis

  • The prognosis for any patient with adrenal insufficiency will depend on the underlying cause. In those patients in whom the prognosis is not affected by the underlying pathology, replacement therapy should result in a return to health.[patient.info]
  • Prognosis & Response totherapyLife expectancy is usually normal with good compliance.It is important to make sure that pt is taking medications regularly and knowledgeable about his condition.BP without orthostatic hypotension, normal lytes, PRA 28.[slideshare.net]
  • In spite of treatment with sulphonamides, antibiotics, and steroids, the prognosis is still extremely poor.[intechopen.com]
  • […] normally presents concurrently with pulmonary TB Clinical features Diagnosis Sepsis tuberculous accutissima (Landouzy septicemia, typhobacillosis of Landouzy) Description: septic progression of primary TB in an immunocompromised patient with a very poor prognosis[amboss.com]
  • Prognosis Requires lifetime treatment: Life expectancy approximates normal with adequate replacement therapy; without treatment, the disease is 100% lethal.[unboundmedicine.com]

Etiology

  • Abstract Since Addison's classic and comprehensive description of the disease bearing his name, 1, 2 accepted etiologic factors have included tuberculosis and cytotoxic contracted adrenals (atrophy) almost exclusively.[annals.org]
  • At 1855, when Addison described it tuberculosis (TB) was the main etiology. May be we are coming to that time. TB is an infectious disease caused by Mycobacterium tuberculosis .[endocrine-abstracts.org]
  • Pathogen host: predominantly humans Mycobacterium bovis : Common pathogen causing gastrointestinal tuberculosis Mechanism of infection: predominantly via ingestion of contaminated cow's milk Pathogen reservoir: predominantly cattle References: [4] [5] Etiology[amboss.com]
  • DISCUSSION Primary adrenal insufficiency is caused by destruction of adrenocortical tissue due to autoimmune disease, tuberculosis, cryptococcosis, fungal infection, and metastatic tumors, among other etiologies.[e-sciencecentral.org]

Epidemiology

  • Epidemiology Sex : (2:1) United States Globally The incidence of multidrug-resistant tuberculosis is steadily rising. References: [1] [2] [3] Epidemiological data refers to the US, unless otherwise specified.[amboss.com]
  • EPIDEMIOLOGY Prevalence: 12 per 100,000 persons Incidence: 0.5 per 100,000 persons Age: may occur at any age, with peak incidence in the fourth decade Sex: Autoimmune causes: female predominance Non-autoimmune causes: equal sex distribution 10.[slideshare.net]
  • […] process, and/or acute withdrawal of long-term corticosteroid therapy (defined as 3 months use of steroid) System(s) affected: endocrine/metabolic Synonym(s): adrenocortical insufficiency; corticoadrenal insufficiency; primary adrenocortical insufficiency Epidemiology[unboundmedicine.com]
  • Epidemiology [ 1, 2 ] Primary insufficiency - this is a relatively rare condition. The annual incidence is about 1 in 10,000 people, with a prevalence in the UK of about 8,400. Across Europe, prevalence is estimated as 93-144 per million.[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • References: [7] [8] [9] Pathophysiology Clinical features Latent infection Asymptomatic The patient is not contagious.[amboss.com]
  • […] the body, especially lung ), hemorrhage (e.g. in Waterhouse–Friderichsen syndrome or antiphospholipid syndrome ), particular infections ( tuberculosis, histoplasmosis, coccidioidomycosis ), or the deposition of abnormal protein in amyloidosis. [22] Pathophysiology[en.wikipedia.org]
  • Predominant sex: females and children males (slight) No racial predilection Incidence 0.6/100,000 Prevalence 40 to 60 cases in 1 million population Etiology and Pathophysiology Autoimmune adrenal insufficiency ( 80% in United States) Infectious causes[unboundmedicine.com]
  • The pathophysiology of this is not yet clear. It involves reduction in the production of glucocorticoids as well as reduced effect.[patient.info]
  • The main causes of sudden death due to adrenal gland pathology will be examined, paying particular attention to the pathophysiology of sudden death, macroscopic and microscopic characteristics and their correlation with clinical features.[intechopen.com]

Prevention

  • Adrenal metastases were thus excluded and probably Addison's disease, considered to be a potential complication of adrenal tuberculosis, could be prevented.[ncbi.nlm.nih.gov]
  • Chronic steroid use, then experiencing severe infection, trauma, or surgical procedures General Prevention Focus on prevention of complications. Anticipate adrenal crisis and treat before symptoms begin.[unboundmedicine.com]
  • There is no evidence that treatment can prevent this autoimmune attack, which may also affect other organs in the same person.[netdoctor.co.uk]
  • References: [4] [25] [26] [27] [28] [29] Prevention[amboss.com]

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