Pseudotumoral Adrenal Tuberculosis

Abstract

Tuberculosis is rare nowadays, however, it should be kept in mind in the differential diagnosis of adrenal insufficiency notably in developing countries or in immunocompromised patients. We report here a case of adrenal insufficiency secondary to tuberculosis with bilateral adrenal masses. A 45 years old man was admitted to our department for investigation of a primary adrenal failure. His past medical history was significant for pleural tuberculosis eighteen years ago. He reported several months’ history of generalized weakness and unintentional weight loss. On physical examination, he presented diffuse hyperpigmentation. On hormonal assessment, there was low basal cortisol level and a high level of corticotrophin. Computed tomography scan showed bilaterally enlarged adrenal glands. The tuberculin skin test was positive. With the background of tuberculosis, adrenal insufficiency diagnosed by laboratory test and positive tuberculin skin test, bilateral enlargement of adrenal glands was considered most consistent with tuberculosis. Tuberculosis remains a classic cause of adrenal insufficiency with adrenal masses. Therefore, it needs to be considered in the differential diagnosis of adrenal insufficiency or bilateral adrenal masses.