Primary adrenal insufficiency in patients with acquired immunodeficiency syndrome: report of four cases
Yi-Wen Huang, Ching-Chung Chang, Hsin-Yun Sun, Mao-Yuan Chen, Chien-Ching Hung, Shan-Chwen Chang
Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei; and Department of Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan, ROC
Received: August 17, 2003 Revised: October 23, 2003 Accepted: November 3, 2003
Dr. Chien-Ching Hung, Department of Internal Medicine, National Taiwan University Hospital, 7 Chung-Shan South Road, Taipei, Taiwan, ROC.
Adrenal insufficiency, though rare, is a well-known complication of acquired immunodeficiency syndrome (AIDS). Over the past 9 years at the National Taiwan University Hospital, 4 patients were diagnosed with primary adrenal insufficiency among 854 non-hemophiliac patients with human immunodeficiency virus infection, with an incidence of 0.19 per 100 patient-years (95% confidence interval, 0.17-0.21 per 100 patient-years). All of the 4 patients were severely immunosuppressed and had been diagnosed with at least 1 AIDS-defining opportunistic illness ever reported to produce adrenal insufficiency in AIDS patients. In 1 of the patients, fluconazole was considered contributory to the development of adrenal insufficiency after treatment at a daily dose of 800 mg for 68 days.
Acquired immunodeficiency syndrome, adrenal gland diseases, opportunistic infections, pneumocystis pneumonia
J Microbiol Immunol Infect 2004;37:250-253.