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ADRENAL HISTOPLASMOSIS: AN EASTERN INDIAN PERSPECTIVE.

S S Agrawal1, P P Chakraborty1, A Sinha1

  • 1Endocrinology & Metabolism Medical College and Hospital Kolkata, West Bengal, India.

Acta Endocrinologica (Bucharest, Romania : 2005)
|August 17, 2022
PubMed
Summary
This summary is machine-generated.

Histoplasmosis can cause adrenal masses, necessitating its consideration in differential diagnoses. While treatment is effective, long-term hydrocortisone may be required, though mineralocorticoid function often recovers.

Keywords:
Adrenal histoplasmosisBilateral adrenal massPrimary adrenal insufficiencySubclinical adrenal insufficiency

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Area of Science:

  • Endocrinology
  • Infectious Diseases
  • Radiology

Background:

  • Histoplasmosis is a fungal infection with varied clinical presentations.
  • Adrenal involvement is a known complication, making it a crucial differential diagnosis for adrenal masses.

Observation:

  • This retrospective study analyzed 9 confirmed cases of adrenal histoplasmosis in Eastern India.
  • Patients presented with bilateral adrenal masses, with or without symptoms of adrenal insufficiency or pyrexia of unknown origin.

Findings:

  • 44.4% of patients had predisposing immunocompromised conditions (diabetes, alcoholism).
  • 77.8% showed signs of adrenal insufficiency; 22.2% presented with fever.
  • All patients had bilateral adrenal masses with diverse radiological appearances.

Implications:

  • Adrenal histoplasmosis should be considered in patients with bilateral adrenal masses, regardless of imaging characteristics.
  • Antifungal treatment is effective, but long-term corticosteroid replacement (hydrocortisone) is often necessary.
  • While adrenocortical function may not fully recover, mineralocorticoid deficiency is typically temporary.