Bouknani Nawal, Bentaleb Daoud, Belgadir Hasna, Amriss Omar, Moussali Nadia, Elbenna Naima
Service de Radiologie 20 Aout 1953, CHU Ibn Rochd de Casablanca, Casablanca, Maroc.
Pan Afr Med J. 2018 Apr 13;29:212. doi: 10.11604/pamj.2018.29.212.15459. eCollection 2018.
Isolated adrenal tuberculosis accounts for less than 2% of adrenal incidentalomas. This is the most frequent infectious cause of adrenal insufficiencies. We report the case of a 53-year old patient with no previous medical history presenting with adrenal insufficiency with slow progression over six months. Physical examination didn't show any mass or hepatosplenomegaly. Blood pressure was 120/60 mmHg. Laboratory tests didn't show inflammatory syndrome. LDH level was normal. CT scan showed bilateral hypertrophy of the adrenal glands characterized by calcifications. Intradermo tuberculin reaction was positive at 25mm. The analyses to detect Koch's bacillus in the sputum and in the urine were negative. Quantiferon test was positive. Trial antibacillar treatment was started with clinical improvement and 5kg weight gain in 12 months. Hormonal assays were low.
孤立性肾上腺结核占肾上腺偶发瘤的比例不到2%。这是肾上腺功能不全最常见的感染原因。我们报告一例53岁患者，既往无病史，出现肾上腺功能不全，病程长达6个月且进展缓慢。体格检查未发现任何肿块或肝脾肿大。血压为120/60 mmHg。实验室检查未显示炎症综合征。乳酸脱氢酶水平正常。CT扫描显示肾上腺双侧肥大，伴有钙化。结核菌素皮内反应在25mm处呈阳性。痰液和尿液中检测结核杆菌的分析结果为阴性。结核感染T细胞检测呈阳性。开始进行抗结核治疗试验，患者临床症状改善，12个月内体重增加5kg。激素检测结果偏低。
