Sarcoidosis Presenting Addison's Disease

We herein describe a second Japanese case of sarcoidosis presenting Addison's disease. A 52-year-old man was diagnosed with sarcoidosis based on clinical and laboratory findings, including bilateral hilar lymphadenopathy and elevated levels of serum angiotensin-converting enzyme and lysozyme, a...

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Bibliographic Details
Published in:Internal Medicine 2016, Vol.55(9), pp.1223-1228
Main Authors: Takahashi, Kentaro, Kagami, Shin-ichiro, Kawashima, Hirotoshi, Kashiwakuma, Daisuke, Suzuki, Yoshio, Iwamoto, Itsuo
Format: Article
Language:English
Subjects:
Addison Disease - diagnosis
Addison's disease
Adrenal Glands - pathology
adrenal insufficiency
Diagnosis, Differential
Fatigue - physiopathology
Granuloma - pathology
Humans
Hyponatremia - pathology
Lymphatic Diseases - pathology
Male
Middle Aged
Peptidyl-Dipeptidase A - analysis
positron emission tomography
sarcoidosis
Sarcoidosis - diagnosis
Sarcoidosis - pathology
Sarcoidosis - physiopathology
steroid psychosis
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Summary:We herein describe a second Japanese case of sarcoidosis presenting Addison's disease. A 52-year-old man was diagnosed with sarcoidosis based on clinical and laboratory findings, including bilateral hilar lymphadenopathy and elevated levels of serum angiotensin-converting enzyme and lysozyme, as well as the presence of noncaseating epithelioid granulomas. The patient also exhibited general fatigue, pigmentation, weight loss, hypotension and hyponatremia, suggestive of chronic adrenocortical insufficiency. An endocrine examination confirmed primary adrenocortical insufficiency. This case suggests the direct involvement of sarcoid granuloma in the adrenal glands.
ISSN:0918-2918
1349-7235
DOI:10.2169/internalmedicine.55.5392