![]() ![]() Primary adrenal insufficiency secondary to TB was the presumptive diagnosis, and the patient was started on adrenal replacement therapy and anti-tubercular therapy. However, Mycobacterial stains, cultures, and Polymerase Chain Reaction (PCR) results were negative. CT scans of the abdomen and pelvis showed diffuse, enlarged adrenal glands with a 5.8 cm mass in the left adrenal gland, the biopsy of which showed chronic inflammation with Langerhans giant cells. Tuberculin skin test (Purified Protein Derivate-PPD) and QuantiFERON test were positive. He failed the cosyntropin stimulation test. Morning cortisol level was low, with very high Adrenocorticotropic Hormone (ACTH). We described a case report, and we performed all the possible investigations to confirm the diagnosis.Ī 38 year old man was admitted with signs and symptoms of adrenal insufficiency. Our objective is to identify diagnostic clues indicative of primary adrenal insufficiency secondary to Tuberculosis (TB) in a patient with negative Mycobacterium TB PCR analysis. ![]()
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