Generalized Hyperpigmentation Caused by Addison’s Disease in a Patient with HIV/AIDS and Multiple Opportunistic Infections

Authors

  • Laurentius Aswin Pramono Department of Internal Medicine, Faculty of Medicine University of Indonesia
  • Dyah Purnamasari
  • Tri J. E. Tarigan
  • Em Yunir
  • Evy Yunihastuti
  • Sondang Panjaitan

Keywords:

Addison’s disease, opportunistic infection, CMV adrenalitis, HIV/AIDS endocrinopathy, generalized hyperpigmentation

Abstract

One of the neglected complications  of  patients with HIV/AIDS is primary adrenal insufficiency also known as Addison’s disease. This condition can be caused by several mechanisms, such as tuberculosis, CMV, cryptococcal, or HIV-related adrenalitis, and also drugs commonly used for HIV/AIDS especially antifungal therapy. This is a case report of a man infected with HIV/AIDS and multiple opportunistic infections. He reported darkening of the skin and reduction of body hair 4 months after diagnosis of HIV/AIDS. From the clinical features and laboratory examinations, he was diagnosed as having primary adrenal insufficiency and was then treated with longterm corticosteroids.

Downloads

Download data is not yet available.

References

Tripathy SK, Agrawala RK, Baliarsinha AK, et al. Endocrine alterations in HIV-infected patients. Indian J Endocrinol Metab. 2015;19(1):143-7. http://dx.doi.org/10.4103/2230-8210.146870.

Grunfeld C, Lee G. AIDS endocrinopathies. In: Gardner DG, Shoback D, eds. Greenspan’s Basic and Clinical Endocrinology. 8th edition. San Fransisco: McGrawHill Companies, ch. 25, pp. 894-908, 2007.

Fujii K, Morimoto I, Wake A, et al. Adrenal insufficiency in a patient with Acquired Immunodeficiency Syndrome. Endocr J. 1994;41(1):13-8. http://dx.doi.org/10.1507/endocrj.41.13.

Betterle C, Scarpa R, Garelli S, Morlin L, Lassarotto F, Presotto F, et al. Addison’s disease: A survey on 633 patients in Padova. Eur J Endocrinol. 2013;169:773-84. http://dx.doi.org/10.1530/EJE-13-0528.

Raff H, Sharma ST, Nieman LK. Physiological basis for the etiology, diagnosis, and treatment of adrenal disorders: Cushing’s syndrome, adrenal insufficiency, and congenital adrenal hyperplasia. Compr Physiol. 2014;4(2):739-69.

http://dx.doi.org/10.1002/cphy.c130035.

Takasawa A, Morimoto I, Wake A, et al. Autopsy findings of Addison’s disease caused by systemic cytomegalovirus infection in a patient with Acquired Immunodeficiency Syndrome. Intern Med. 1995;34(6):533-6.

http://dx.doi.org/10.2169/internalmedicine.34.533.

Patnaik MM, Deshpande AK. Diagnosis- Addison’s disease secondary to tuberculosis of the adrenal glands. Clin Med Res. 2008;6(1):29. http://dx.doi.org/10.3121/cmr.2007.754a.

Hung ZS, Lai YH, Hsu YH, Wang CH, Fang TC, Hsu BG. Disseminated cryptococcosis causes adrenal insufficiency in an immunocompetent individual. Intern Med. 2010;49(11):1023-6. http://dx.doi.org/10.2169/internalmedicine.49.3051.

Gradon JD, Sepkowitz DV. Fluconazole-associated acute adrenal insufficiency. Postgrad Med J. 1991;67(794):1084-5.

Albert SG, DeLeon MJ, Silverberg AB. Possible association between high-dose fluconazole and adrenal insufficiency in critically ill patients. Crit Care Med. 2011;29(3):668-70.

Krishnan SGS, Cobbs RK. Reversible acute adrenal insufficiency caused by fluconazole in a critically ill patient. Postgrad Med J. 2006;82(971):e23. http://dx.doi.org/10.1136/pgmj.2006.047258.

Van der Pas R, Hofland LJ, Hofland J, Taylor AE, Arlt W, Steenbergen J, et al. Fluconazole inhibits human adrenocortical steroidogenesis in vitro. J Endocrinol. 2012;215:403-12. http://dx.doi.org/10.1530/JOE-12-0310.

Mussio Fournier JC, Pollack E, Lussich Siri JJ. Loss of axillary and pubic hair in a patient ith Addison’s disease and regular menstruation: A case report. J Clin Endocrinol Metab. 1949;9(6):555. http://dx.doi.org/10.1210/jcem-9-6-555.

Michels A, Michels N. Addison disease: Early detection and treatment principles. Am Fam Physician. 2014;89(7):563-8.

Grossman A, Johannsson G, Quinkler M, Zelissen P. Therapy of Endocrine Disease: Perspectives on the management of adrenal insufficiency: Clinical insights from across Europe. Eur J Endocrinol. 2013;169:R165-75. http://dx.doi.org/10.1530/EJE-13-0450.

Published

2015-11-30

How to Cite

Pramono, L. A., Purnamasari, D., Tarigan, T. J. E., Yunir, E., Yunihastuti, E., & Panjaitan, S. (2015). Generalized Hyperpigmentation Caused by Addison’s Disease in a Patient with HIV/AIDS and Multiple Opportunistic Infections. Journal of the ASEAN Federation of Endocrine Societies, 30(2), 167. Retrieved from https://asean-endocrinejournal.org/index.php/JAFES/article/view/244

Issue

Section

Case Reports

Most read articles by the same author(s)

1 2 > >>