Tuberculosis of Adrenal Glands-A Population-based Case-control Study

Area of Science:

• Endocrinology
• Infectious Diseases
• Oncology

Background:

• Adrenal tuberculosis (ATB) is an uncommon condition that can lead to primary adrenal insufficiency (PAI) or be misdiagnosed as nonfunctional adrenal tumors (NFATs).
• Limited data exists on the epidemiology of ATB in modern, high-income countries.

Purpose of the Study:

• To investigate the prevalence of adrenal involvement in patients diagnosed with tuberculosis.
• To determine the association between adrenal tuberculosis and mortality rates.

Main Methods:

• A national register-based study compared patients with tuberculosis and adrenal lesions to controls without adrenal tumors.
• Mortality analysis included individuals with ATB or possible adrenal involvement (tuberculosis and NFAT), with adjustments for age and sex.

Main Results:

• The study identified 8 patients with ATB, 34 with tuberculosis and NFAT, and 129 controls with tuberculosis.
• Patients with tuberculosis had an increased risk of adrenal tumors (OR, 1.64).
• Adrenal tuberculosis was strongly associated with increased mortality (aHR, 6.2), with PAI contributing to 67% of deaths.

Conclusions:

• Adrenal tuberculosis is a rare condition in high-income settings.
• The majority of patients with ATB present with PAI, and there is a significantly increased risk of mortality.
• Increased vigilance for ATB in tuberculosis patients is warranted, especially those with adrenal lesions or PAI.