Dificultades diagnósticas en un caso de enfermedad de Addison de origen tuberculoso

Addison's disease is an uncommon entity. Diagnosis is usually obvious in patients with adrenal crisis. However, in its early stage, Addison's disease is usually underdiagnosed, given that the loss of adrenal function is often progressive, with gradual and insidious onset of symptoms, most of which are nonspecific. In many parts of the world, tuberculosis or fungal infections are highly prevalent and remain the principal cause of adrenal insufficiency. In western countries, however, adrenal insufficiency due to infectious agents is relatively uncommon. We present a case of tuberculous Addison's disease, with typical clinical and radiological development of adrenal tuberculosis. We also review the difficulties posed by the diagnosis and treatment of this disease.