Acute Adrenal Insufficiency as the Primary Manifestation of Extrapulmonary Tuberculosis: A Case Report

Authors

  • Herman Trianto Department of Internal Medicine, Faculty of Medicine Brawijaya University – dr. Saiful Anwar General Hospital
  • Nurria Betty Endocrinology, Metabolic Disease and Diabetes Division, Internal Medicine Department Brawijaya University - Saiful Anwar General Hospital Malang
  • Laksmi Sasiarini Endocrinology, Metabolic Disease and Diabetes Division, Internal Medicine Department Brawijaya University - Saiful Anwar General Hospital Malang
  • Rulli Rosandi Endocrinology, Metabolic Disease and Diabetes Division, Internal Medicine Department Brawijaya University - Saiful Anwar General Hospital Malang
  • Putu Arsana Endocrinology, Metabolic Disease and Diabetes Division, Internal Medicine Department Brawijaya University - Saiful Anwar General Hospital Malang
  • Djoko Soeatmadji Endocrinology, Metabolic Disease and Diabetes Division, Internal Medicine Department Brawijaya University - Saiful Anwar General Hospital Malang
  • Achmad Rudijanto Endocrinology, Metabolic Disease and Diabetes Division, Internal Medicine Department Brawijaya University - Saiful Anwar General Hospital Malang

Keywords:

Addison’s disease, acute adrenal insufficiency, serum cortisol, urinary symptoms, tuberculosis

Abstract

>Acute adrenal insufficiency (AI) is a life-threatening condition. While Addison’s disease (AD) is rare, in developing countries, tuberculosis (TB) still remains as the primary cause in 7 to 20% of cases. Urinary TB is also the third most common form of extrapulmonary disease. We report a case of 37-year-old male who presented with weakness, anorexia, weight loss, dysuria, flank pain and low grade fever. Examination revealed hypotension, hyperpigmentation, hyponatremia, hypoglycemia and low serum cortisol. He was diagnosed to have adrenal crisis due to Addison’s disease and extrapulmonary TB manifesting as urinary tract infection (UTI). He was treated with corticosteroids and anti-TB medications. Urologic reconstructive surgery was subsequently planned.

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Author Biography

Herman Trianto, Department of Internal Medicine, Faculty of Medicine Brawijaya University – dr. Saiful Anwar General Hospital

Supervisor, Consultant of Endocrinology and Metabolic Disease Division

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Published

2016-05-26

How to Cite

Trianto, H., Betty, N., Sasiarini, L., Rosandi, R., Arsana, P., Soeatmadji, D., & Rudijanto, A. (2016). Acute Adrenal Insufficiency as the Primary Manifestation of Extrapulmonary Tuberculosis: A Case Report. Journal of the ASEAN Federation of Endocrine Societies, 31(1), 59. Retrieved from https://asean-endocrinejournal.org/index.php/JAFES/article/view/256

Issue

Vol. 31 No. 1 (2016): May Issue

Section

Case Reports

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