Addison’s Disease Caused by Tuberculosis: Diagnostic and Therapeutic Difficulties

Authors

• Sanne van Haren Noman Department of Internal Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands
• Hannah Visser Department of Internal Medicine, Beatrixziekenhuis, Gorinchem, The Netherlands
• Alex Muller Department of Internal Medicine, Diakonessenhuis Utrecht, Utrecht, The Netherlands
• Gijs Limonard epartment of Pulmonary Diseases and Tuberculosis, Diakonessenhuis Utrecht, Utrecht, The Netherlands

sannevhn@gmail.com

Keywords

Abstract

Objectives: To demonstrate difficulties in diagnosing and treating Addison’s disease caused by tuberculosis.
Materials and methods: We present a clinical case and review of the literature.
Results: A 62-year-old man presented with gastrointestinal symptoms, weight loss and enlarged adrenal glands. After 2 months of diagnostic tests, a working diagnosis of Addison’s disease due to extrapulmonary tuberculosis was made. Treatment was challenging due to interaction between rifampicin and steroids.
Conclusion: Our case illustrates that in non-endemic countries, extrapulmonary tuberculosis still needs to be considered as a possible cause of Addison’s disease.