Insuficiencia suprarrenal primaria y tuberculosis  sistémica en un varón de 10 años. Reporte de caso

Sandra Schult-Montoya; Felipe Ricardo Lindo-Pérez

doi:10.17843/rpmesp.2025.421.14092

Authors

Sandra Schult-Montoya Instituto Nacional de Salud del Niño, Lima, Perú. Universidad Nacional Mayor de San Marcos, Lima, Perú https://orcid.org/0000-0002-9189-7778
Felipe Ricardo Lindo-Pérez Instituto Nacional de Salud del Niño, Lima, Perú https://orcid.org/0009-0000-8665-5929

DOI:

https://doi.org/10.17843/rpmesp.2025.421.14092

Keywords:

Primary adrenal insufficiency, Addison’s disease, multisystemic TB, tuberculous adrenalitis, pediatrics

Abstract

Primary adrenal insufficiency is the result of impaired steroid synthesis, adrenal destruction or abnormal development of the adrenal gland affecting the adrenal cortex. Tuberculosis is one of the main causes in developing countries. We present the case of a 10-year-old male patient diagnosed with adrenal insufficiency
two years earlier with regular treatment, who was admitted for adrenal crisis. A thoraco-abdominal
tomography was carried out during hospitalization, which showed cylindrical and traction bronchiectasis
associated with cicatricial atelectasis in the right upper pulmonary lobe, enlarged adrenal glands with foci of calcification, as well as a dense posterior perivertebral mediastinal collection also involving vertebral bodies with lytic resorptive foci, findings consistent with systemic tuberculosis. Treatment for tuberculosis started based on this diagnosis. During course of the disease, the first phase was completed with four drugs, and the second phase included isoniazid and rifampicin with favorable clinical response.

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