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| Content Provider | Springer Nature : BioMed Central |
|---|---|
| Author | Kaneto, Hideaki Tatsumi, Fuminori Ohnishi, Mana Iwamoto, Yuichiro Katakura, Yukino Shimoda, Masashi Nakanishi, Shuhei Kaku, Kohei Mune, Tomoatsu |
| Abstract | 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. |
| Related Links | https://bmcendocrdisord.biomedcentral.com/counter/pdf/10.1186/s12902-022-01178-1.pdf |
| Ending Page | 6 |
| Page Count | 6 |
| Starting Page | 1 |
| File Format | HTM / HTML |
| ISSN | 14726823 |
| DOI | 10.1186/s12902-022-01178-1 |
| Journal | BMC Endocrine Disorders |
| Issue Number | 1 |
| Volume Number | 22 |
| Language | English |
| Publisher | BioMed Central |
| Publisher Date | 2022-10-23 |
| Access Restriction | Open |
| Subject Keyword | Endocrinology Metabolic Diseases Diabetes Andrology Mycobacterium abscessus Mycobacterium avium complex pulmonary disease Case report Addison’s disease Non-tuberculous mycobacterial infection |
| Content Type | Text |
| Resource Type | Case study |
| Subject | Endocrinology, Diabetes and Metabolism |
| Journal Impact Factor | 2.8/2023 |
| 5-Year Journal Impact Factor | 3.1/2023 |
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