SFE2002 Poster Presentations Clinical case reports (21 abstracts)
HISTOPLASMOSIS, A RARE CAUSE OF ADDISON`S DISEASE: CASE REPORT
G Vargas 1 , M Monteiro 1 , A Santos 1 , I Calhim 2 , R Pina 2 , M Correia 3 , V Lopes 4 , R Carvalho 1 & H Ramos 1
1Department of Endocrinology, Hospital Geral de Santo Antonio, Porto, Portugal; 2Department of Pathology, Hospital Geral de Santo Antonio, Porto, Portugal; 3Department of Surgery, Hospital Geral de Santo Antonio, Porto, Portugal; 4Department of Microbiology, Hospital Geral de Santo Antonio, Porto, Portugal.
Background: Fungal infections are a rare cause of primary adrenal insufficiency, raising difficulties in the diagnostic and therapeutic approaches.
Case report: A 56 years old diabetic male, who lived in Guinea in 1968, was referred to our inpatients clinic because of a 7,7x3 cm adrenal incidentaloma. He presented with hyperpigmentation, postural symptoms, weakness, fatigue, anorexia and weight loss.
The rapid ACTH stimulation test had a subnormal response and ACTH was
1144 pg/ml. The screening for pheochromocytoma was negative.
He was submitted to left adrenal resection. The other gland had no macroscopic evidence of tumours.
The histological exam identified a fungal agent, Hystoplasma capsulatum.
He is under treatment with Hidrocortisone, Fluodrocortisone and Itraconazole.
Comments: This is a rare cause of Addisons`disease. However, as tuberculosis became less frequent, fungal disease is a more common cause of adrenal gland infection, particularly if the patient lives in an endemic area. The accurate diagnosis has implications in therapeutic approach.
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Endocrine Abstracts
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