Addison's disease occurring in late stage of antituberculosis treatment Antitüberküloz tedaviye baǧli geç oluşan Addison olgusu

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Şentürk A., KILIÇ H., Karaduman-Yalçin F., HASANOĞLU H. C.

Turk Hijyen ve Deneysel Biyoloji Dergisi, cilt.71, sa.1, ss.35-40, 2014 (Scopus, TRDizin)

Özet

Addison's Disease that evolved due to infection or caused by autoimmune disease is a hypofunction of the adrenal gland. Addisson's Disease might develop due to microsomal enzyme induction associated with treatment with Rifampisin. It is noted that the case reports of those who were diagnosed with Addison's Disease after the antituberculosis treatment had been started. However, there are no cases where Addison's Disease developed in the late period of antituberculosis treatment in the literature. A fourty eight year old female patient applied to our policlinic with complaints of weakness, twenty kg weight loss and difficulty in swallowing nine months ago. There was no history of tuberculosis in the patients background. It wasn't determined from pathological sign on her examination and endoscopy in the policlinic of Gastroenterology. She didn'n have comorbid disease. Cough, sputum, hemoptysy, dyspnoe, chest pain, fever and night sweating were not in her complaints. Chest examination were normal. There was no hepatosplenomegaly. Serum hemogram, sedimentation and C-reactive protein were normal. PPD: 20 mm, Serum angioconverting enzym value: 30 mg/dl (8-52 mg/dl). Posteroanterior chest CAT scan was normal. There were not any other signs except subcarinal lymph nodes which are seen on thorax computarised tomograpy. Endobronchial lesion was not on her bronchoscopy. Asidoresistanbasil (ARB), Mycobcteria Polymerase Chain Reaction (PCR) was negative in her bronchial lavage. Transbronchial needle aspiration (TBNA) awas taken from a subcranial, hypoechoic, calcified lymph node of 35 mm using Endobronchial Ultrasound (EBUS). Patient was diagnosed with mediastinal tuberculosis due to granuloma containing calcification by pathologist on her biopsy. While she was taking antituberculosis treatment, her radiological signs were improved in follow up. However, she with the same complaints on the eighth month of treatment. Because of hyperpigmentatiton seen on her examination, she was evaulated by endocrinologist and diagnosed with Addisson's Disease. Corticosteroid treatment was to the patient and clinical improvement was achieved. This case was reported because while she was taking antituberculosis treatment on the eighth month, Addison's Disease had developed in the patient.