Adrenal Histoplasmosis and Tuberculosis: Clinical Presentations and a High Prevalence of Adrenal Insufficiency
Authors' conclusion
Adrenal histoplasmosis and TB primarily affected non-HIV males. Most patients presented with bilateral adrenal masses. The prevalence of AI was high and likely persistent despite specific treatment. Extra-adrenal infections were common in TB and coinfection but were insufficient to determine adrenal infection etiology, highlighting the need for tissue diagnosis.
Study context
- Population
- Patients with microbiologically confirmed adrenal histoplasmosis and tuberculosis (TB) at two referral centers in Bangkok, Thailand; mostly non-HIV (97%) males (91%), mean age 64 years
- Participants
- 35 patients
- Exposure
- Adrenal histoplasmosis vs Adrenal TB vs Coinfection
- Adrenal histoplasmosisn = 31
- Adrenal TBn = 3
- Coinfectionn = 1
- Outcome
- Clinical presentations, imaging characteristics and AI prevalence in adrenal infections
Methodological detailstwo referral centres
- Two referral centres
Main finding
As reported in the abstract
Prevalence of AI
- Overall prevalence of adrenal insufficiency (AI)
- 74%
Observational data: associations, not effects.
Further findings
Extra-adrenal infections
- Extra-adrenal infections — Adrenal histoplasmosis with concurrent extra-adrenal TB
- 10%
Presenting symptoms
- Anorexia and weight loss
- 91%
- Adrenal crisis at presentation
- 26%
Imaging
- Bilateral adrenal abnormalities
- 91%
- Adrenal lesions ranged from enlargement to mass sized
- 9.8 cm
- All with unilateral lesions later developed contralateral involvement
Persistence of AI · median follow-up 22 months
- All patients with AI remained on glucocorticoid supplements
Original publication
Adrenal Histoplasmosis and Tuberculosis: Clinical Presentations and a High Prevalence of Adrenal Insufficiency. Clin Endocrinol (Oxf). Published 9 April 2025. doi:10.
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