Highlights that cryptococcosis can cause massive destruction of the adrenal glands leading to adrenal insufficiency, and notes the diagnostic value of CT scanning.
Raises awareness for cryptococcal adrenal insufficiency; extends sparse antemortem data but leaves open CT screening utility.
UNTIL the mid-1930s, tuberculosis had traditionally been considered to be the most frequent cause of primary adrenal insufficiency. With a progressive decrease in the prevalence of this granulomatous process, however, autoimmune disease has superseded tuberculosis as the most frequent cause of primary adrenal insufficiency.1It is amply documented, nevertheless, that certain fungal diseases such as histoplasmosis as well as neoplasms may destroy sufficient adrenal tissue to produce the signs and symptoms of Addison's disease.2-4It is our purpose herein to point out the less well-known fact that other fungal diseases, by means of massive destruction of the adrenal glands, may likewise produce adrenal insufficiency. Specifically, we detail what to the best of our knowledge is the second reported, antemortem biochemically and histopathologically confirmed documentation of cryptococcal-induced adrenal cortical insufficiency. We likewise point out the value of computed tomographic (CT) scanning of the adrenal glands to assist in the
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Bharat Shah (1986) studied this question.
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