Tomographic diagnosis of primary adrenal tuberculosis in Addison's disease at altitude. Case report

Dávila-Aranda B.; Córdova-Valenzuela V.; Carrillo-Sanabria G.; Meza-Legua F.; Tinoco-Solórzano A. · Revista de la Facultad de Medicina Humana (2020) · DOI: 10.25176/rfmh.v20i4.2953

Resumen

We report the case of a 23-year-old man, natural and high-altitude resident, with hyperpigmentation, asthenia, fatigue, nausea, vomiting, weight loss, abdominal pain, hyporexia, and hypotension, with decreased cortisol dosage and elevated ACTH. Normal chest X-ray, negative sputum and urine smear, negative TB LAM antigen. The contrast-enhanced computed tomography of the abdomen shows an increase in dimensions and small calcifications in both adrenal glands, suggesting a specific granulomatous infiltration type. In endemic tuberculosis areas such as Peru; In the absence of adrenal biopsy, it can be used early as a diagnostic alternative to tomography to rule out adrenal involvement. In conclusion, this report has described how tomography can be used as an alternative diagnostic method in hospitals where it is not feasible to perform a quick biopsy.

Instituciones: Universidad Peruana Los Andes