Namikawa Hiroki, Takemoto Yasuhiko, Kainuma Shigeto, Umeda Sakurako, Makuuchi Ayako, Fukumoto Kazuo, Kobayashi Masanori, Kinuhata Shigeki, Isaka Yoshihiro, Toyoda Hiromitsu, Kamata Noriko, Tochino Yoshihiro, Hiura Yoshikazu, Morimura Mina, Shuto Taichi
Department of Medical Education and General Practice, Osaka City University, Graduate School of Medicine, Japan.
Department of Diabetes, Osaka City Juso Hospital, Japan.
Intern Med. 2017;56(14):1843-1847. doi: 10.2169/internalmedicine.56.7976. Epub 2017 Jul 15.
We herein report a case of Addison's disease caused by tuberculosis characterized by atypical hyperpigmentation, noted as exacerbation of the pigmentation of freckles and the occurrence of new freckles, that was diagnosed in the presence of active pulmonary tuberculosis. The clinical condition of the patient was markedly ameliorated by the administration of hydrocortisone and anti-tuberculosis agents. When exacerbation of the pigmentation of the freckles and/or the occurrence of new freckles are noted, Addison's disease should be considered as part of the differential diagnosis. In addition, the presence of active tuberculosis needs to be assumed whenever we treat patients with Addison's disease caused by tuberculosis, despite its rarity.
我们在此报告一例由结核病引起的艾迪生病病例，其特征为非典型色素沉着，表现为雀斑色素沉着加重及出现新的雀斑，该病例在活动性肺结核存在的情况下被诊断出来。通过给予氢化可的松和抗结核药物，患者的临床状况得到明显改善。当发现雀斑色素沉着加重和/或出现新的雀斑时，应将艾迪生病作为鉴别诊断的一部分加以考虑。此外，尽管由结核病引起的艾迪生病较为罕见，但在治疗此类患者时，无论何时都需假定存在活动性肺结核。
