Addison's disease triggered by infection with mycobacterium abscessus, but not by adrenal tuberculosis or MAC pulmonary disease, in a subject with type 2 diabetes mellitus: case report.
Background: Addison's disease is primary adrenal dysfunction and is characterized by decrease of cortisol level and increase of adrenocorticotropic hormone (ACTH) level. It is known that infection is one of main causes of Addison's disease. Among various infections, tuberculous infection accounts fo...
| Publicado en: | BMC Endocrine Disorders Vol. 22; no. 1; pp. 1 - 7 |
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| Autores principales: | , , , , , , , , |
| Formato: | case study diagnostic images pictorial tables/charts Journal Article |
| Publicado: |
BioMed Central
10/23/2022
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=159838278&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 159838278 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 14726823 1CHL jtl: BMC Endocrine Disorders issn: 14726823 maglogo: N pubinfo: dt: 10/23/2022 vid: 22 iid: 1 pid: 24147 pub: BioMed Central artinfo: ui: 159838278 159838278 159838278 10.1186/s12902-022-01178-1 159838278 ppf: 1 ppct: 6 formats: tig: atl: Addison's disease triggered by infection with mycobacterium abscessus, but not by adrenal tuberculosis or MAC pulmonary disease, in a subject with type 2 diabetes mellitus: case report. aug: au: Kaneto, Hideaki Tatsumi, Fuminori Ohnishi, Mana Iwamoto, Yuichiro Katakura, Yukino Shimoda, Masashi Nakanishi, Shuhei Kaku, Kohei Mune, Tomoatsu affil: Department of Diabetes, Endocrinology and Metabolism, Kawasaki Medical School, 577 Matsushima, 701-0192, Kurashiki, Japan sug: subj: Addison's Disease Etiology Mycobacterium Abscessus Mycobacterium Infections Complications Diabetic Patients Diabetes Mellitus, Type 2 Mycobacterium Infections Diagnosis Addison's Disease Diagnosis Female Aged, 80 and Over Tuberculosis Lung Diseases Mycobacterium Avium-Intracellulare Infection Ambulatory Care Hospitalization of Older Persons Pigmentation Face Hand Leg Tomography, X-Ray Computed Radiography, Abdominal Calcinosis Radiography Adrenal Glands Radiography Adrenal Glands Pathology Bronchoalveolar Lavage Microbial Culture and Sensitivity Tests Hydrocortisone Therapeutic Use Treatment Outcomes Aged, 80 & over Female ab: Background: Addison's disease is primary adrenal dysfunction and is characterized by decrease of cortisol level and increase of adrenocorticotropic hormone (ACTH) level. It is known that infection is one of main causes of Addison's disease. Among various infections, tuberculous infection accounts for the majority of them. Recently the number of subjects with non-tuberculous mycobacterial infection has been increased, and the infection can also bring about Addison's disease. Mycobacterium avium complex (MAC) pulmonary disease accounts for the majority of non-tuberculous mycobacterial infection. Case presentation: An 83-year-old female was suspected of having adrenal failure in our outpatient care and hospitalized in our institution. There was pigmentation in her face, hands and legs, especially in auricle and nail beds in her hands and legs. In rapid ACTH load test (0.25 mg of 1–24 ACTH), cortisol level was not increased at all. An abdominal computed tomography (CT) showed swelling of both adrenal glands accompanied by calcification. QuantiFERON test was negative and mycobacterium tuberculosis complex was negative in PCR test using bronchial lung lavage fluid. These data ruled out the possibility of adrenal tuberculosis. It is known that MAC pulmonary disease accounts for the majority of non-tuberculous mycobacterial infection. In this subject, however, anti-MAC antibody was negative and MAC-related bacteria were not detected in PCR test using bronchial lung lavage fluid. These data ruled out the possibility of MAC pulmonary disease. Mycobacterium abscessus (Mab) was positive in bronchial lung lavage fluid culture. Based on these data, we diagnosed this subject with Addison's disease triggered by infection with mycobacterium abscessus, but not by adrenal tuberculous or MAC pulmonary disease. Decreased sodium level and increased eosinophil number were normalized and appetite loss was markedly mitigated after starting hydrocortisone therapy. A chest CT which was taken about 6 months later showed drastic reduction of consolidation in the upper lobe of the left lung although calcification in the adrenal gland was still observed. Conclusions: We should bear in mind the possibility of Addison's disease triggered by another type of infection rather than adrenal tuberculosis or MAC pulmonary disease. pubtype: Academic Journal doctype: case study diagnostic images pictorial tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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