ISSN: 1301-2193 E-ISSN: 1308-9846
  • Turkish Journal of
    Endocrinology and Metabolism
OLGU SUNUMU

Adrenal Yetmezliğe Neden Olan Adrenal Kitle: Tüberküloz
A Case of Adrenal Mass Causing Adrenal Insufficiency: Tuberculosis
1Uludağ University Faculty of Medicine, Department of Endocrinology and Metabolism, Bursa, Turkey
2Uludağ University Faculty of Medicine, Department of Endocrinology and Metabolism, Bursa, Turkey
3Uludağ University Faculty of Medicine, Department of Pathology, Bursa, Turkey
4Uludağ University Faculty of Medicine, Department of Internal Medicine, Bursa, Turkey
5Uludağ University Faculty of Medicine, Department of Endocrinology and Metabolism, Bursa, Turkey
6Uludağ University Faculty of Medicine, Department of Endocrinology and Metabolism, Bursa, Turkey
Doi: 10.4274/tjem.3429 - Makale Dili: EN
ÖZET

Tüberküloz, günümüzde, gelişmiş ülkelerde adrenal yetmezliğin sıklığı giderek azalan nedenlerinden biridir. Bu olgu sunumunda adrenal yetmezlik bulguları ile tanı alan adrenal ve miliyer akciğer tüberkülozlu hastayı sunmayı amaçladık. Yetmiş bir yaşında, daha önce tek taraflı adrenalektomi öyküsü olan kadın hasta adrenal yetmezlik semptomları ile başvurdu. Yapılan tetkiklerinde primer adrenal yetmezlik ve adrenal bezde tüberkülozun adrenal tutulumunu temsil eder nitelikte kitle saptandı. Her iki akciğerde miliyer tüberküloz ile uyumlu nodülleri mevcuttu. Anti-tüberküloz tedavi sonrası hastanın akciğerlerindeki nodüller kayboldu, adrenal kitle boyutlarında küçülme saptanmadı. Adrenalektomi yapılan hasta glukokortikoid ve mineralokortikoid tedavi ile takip edilmektedir. Adrenal tüberküloz gelişmekte olan ülkelerde halen adrenal yetmezliğin sık görülen nedenlerinden biridir. Tüberküloz adrenal bezde harabiyete neden olur ve özellikle adrenal bezde büyüme olan olgularda tanı güçtür.

ABSTRACT

Tuberculosis, the prevalence of which has continued to decline in developed countries, is still one of the reasons of adrenal insufficiency. In this report, we aimed to present a case of adrenal and miliary tuberculosis presenting with adrenal insufficiency. A 71-year-old woman with a history of unilateral adrenalectomy was admitted with the symptoms of adrenal insufficiency. In her further medical investigations, the diagnosis of primary adrenal insufficiency was established and a mass presenting as involvement of tuberculosis was detected in the adrenal gland. Bilateral pulmonary nodules compatible with miliary tuberculosis were observed. After anti-tuberculosis treatment, pulmonary nodules disappeared, but there was no significant decrease in the size of the adrenal mass. The patient, who underwent adrenalectomy, was followed with glucocorticoid and mineralocorticoid treatment. Tuberculosis of the adrenal glands is a common cause of adrenal insufficiency in developing countries. Tuberculosis can destroy the adrenal glands and the diagnosis of adrenal tuberculosis, especially presenting with enlargement of the adrenal glands, can be difficult.