Addison’s Disease Caused by Tuberculosis: Diagnostic and Therapeutic Difficulties

OBJECTIVES: To demonstrate difficulties in diagnosing and treating Addison’s disease caused by tuberculosis. MATERIALS AND METHODS: We present a clinical case and review of the literature. RESULTS: A 62-year-old man presented with gastrointestinal symptoms, weight loss and enlarged adrenal glands. After 2 months of diagnostic tests, a working diagnosis of Addison’s disease due to extrapulmonary tuberculosis was made. Treatment was challenging due to interaction between rifampicin and steroids. CONCLUSION: Our case illustrates that in non-endemic countries, extrapulmonary tuberculosis still needs to be considered as a possible cause of Addison’s disease. LEARNING POINTS: In non-endemic countries, extrapulmonary tuberculosis still needs to be considered as a possible cause of Addison’s disease. Treating tuberculosis and adrenal cortex insufficiency can be challenging because of the interaction between rifampicin and adrenocorticoid drugs. Adrenal function does not recover in most cases of Addison’s disease caused by tuberculosis.