Tuberculous Adrenal Abscess Presenting as Adrenal Insufficiency in a 4-Year-Old Boy

Shreya Sharma1, Rajesh Joshi1, Radhika Kalelkar1

  • 1Division of Pediatric Endocrinology, Bai Jerbai Wadia Hospital for Children, Mumbai, India.

Insights

A young boy with early adrenal insufficiency symptoms was diagnosed with a rare tuberculous adrenal abscess. Treatment involved hormone replacement and specialized multidrug-resistant tuberculosis therapy.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Endocrinology

Background:

  • Adrenal insufficiency in children typically raises suspicion for congenital causes due to early symptom onset.
  • Tuberculosis is an uncommon cause of adrenal insufficiency, particularly in developed nations.
  • Adrenal abscesses are rare, and tuberculous etiology further narrows the differential diagnosis.

Related Concept Videos

Anatomy of the Adrenal Glands01:17

Anatomy of the Adrenal Glands

The adrenal or supra-renal glands, situated above the kidneys and aligned with the twelfth rib, are paired pyramid-shaped structures crucial for the body's stress response. During stress, these glands secrete hormones vital for adaptive physiological reactions.
These glands possess a distinctive yellow tinge due to the stored cholesterol and fatty acids required for hormone synthesis. They are encased in a fibrous capsule and cushioned by fat.
The adrenal gland comprises two distinct...
4.8K
Adrenal Gland Disorders01:27

Adrenal Gland Disorders

Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
3.3K
Hormones of the Adrenal Glands01:31

Hormones of the Adrenal Glands

Adrenal hormones play a pivotal role in maintaining the body's electrolyte balance and orchestrating responses to stress, showcasing the intricate functions of the adrenal cortex and medulla.
The adrenal cortex, a powerhouse of hormone synthesis, generates over two dozen corticosteroid hormones. The zona glomerulosa produces mineralocorticoids, exemplified by aldosterone, influencing the electrolyte composition of body fluids. The synthesis of glucocorticoids such as cortisol and...
5.5K
Sympathetic Pathways: Collateral Ganglia and Adrenal Medulla01:27

Sympathetic Pathways: Collateral Ganglia and Adrenal Medulla

The sympathetic pathways of the collateral ganglia and adrenal medulla serve unique but interconnected roles in the sympathetic response.
Collateral Ganglia
Sympathetic preganglionic axons reach the collateral ganglia along the route of splanchnic nerves. These nerves bypass the sympathetic trunk and communicate with sympathetic postganglionic neurons housed in the prevertebral ganglia. These ganglia supply the organs of the abdominopelvic cavity.
The greater splanchnic nerve, formed by the...
3.0K
Insufficient Sleep and Sleep Deprivation01:13

Insufficient Sleep and Sleep Deprivation

Insufficient sleep refers to not getting the recommended amount of sleep for optimal functioning, even if it's just slightly less than needed. Sleep insufficiency may occur due to lifestyle choices, such as staying up late for social events or work, resulting in routinely getting less sleep than required. For example, consistently sleeping 6 hours when the body needs 7-9 hours can lead to cumulative effects on health and well-being.
Sleep deprivation is a more severe form of sleep loss...
942
Dipeptidyl Peptidase 4 Inhibitors01:23

Dipeptidyl Peptidase 4 Inhibitors

Dipeptidyl peptidase 4 (DPP-4) is a serine protease widely distributed in the body. It's involved in the inactivation of GLP-1 and GIP hormones, which are crucial for insulin regulation. DPP-4 inhibitors, such as sitagliptin (Januvia), saxagliptin (Onglyza), linagliptin (Tradjenta), alogliptin (Nesina), and vildagliptin (Galvus), help increase the proportion of active GLP-1, enhancing insulin secretion. These inhibitors work by competitively binding to DPP-4. This binding causes a...
685