A Case of Tuberculous Addison Disease With Recurrent Nontuberculous Pericarditis

ABSTRACT Objective: It is unknown if the combination of adrenal failure and acute pericarditis have a cause-effect relationship. Methods: A case report and literature review. Results: A 60-year-old man presented with acute pericarditis and adrenal failure. Bilateral adrenal swelling and a positive QuantiFERON test indicated adrenal tuberculosis. Analysis of pericardial effusion fluid indicated a nontuberculous and nonimmune etiology. Administration of stress doses of cortisol resolved the pericarditis. Antitubercular drugs were administered. One year after treatment, acute pericarditis and adrenal failure recurred following overwork. Administration of stress doses of steroid had an immediate effect on resolution of the pericarditis. Conclusion: Acute pericarditis is suspected as a symptom of adrenal failure. The recognition of this clinical presentation will help early diagnosis of adrenal failure and pericarditis. Abbreviations: ACTH = adrenocorticotropic hormone ECG = electrocardiogram