Case Reports in Endocrinology最新文献

{"title":"Discordantly Low HbA1c in Type 1 Diabetes: Undiagnosed G6PD Deficiency Masking Poor Glycemic Control-A Case Report.","authors":"Javeria Khan, Irfan Khan, Muhammad Maaz Bin Zahid, Hoor Qazi, Ayesha Nasir","doi":"10.1155/crie/3927494","DOIUrl":"10.1155/crie/3927494","url":null,"abstract":"<p><strong>Background: </strong>Glycated hemoglobin (HbA1c) is a widely used biomarker for assessing long-term glycemic control in patients suffering from diabetes mellitus. However, certain hematologic conditions, such as hemolytic disorders, can produce misleadingly low HbA1c values, potentially masking poor glycemic control and leading to mismanagement of the patient. This case represents a rare but clinically significant scenario, where G6PD deficiency leads to spuriously low HbA1c level, emphasizing the need for alternative glycemic markers.</p><p><strong>Case presentation: </strong>We report the case of a 17-year-old male who presented with classic symptoms of hyperglycemia and was diagnosed with type 1 diabetes mellitus (T1DM) based on clinical features, elevated blood glucose, high HbA1c (>14%), and positive glutamic acid decarboxylase (GAD) antibodies. One month after initiating basal-bolus insulin therapy, his follow-up HbA1c unexpectedly dropped to 3%, despite continuous glucose monitoring (CGM) showing incomplete control of glucose level. Work-up for nonglycemic factors, specifically those affecting the red blood cells (RBCs) revealed normal hemoglobin electrophoresis but confirmed glucose-6-phosphate dehydrogenase (G6PD) deficiency. The intravascular hemolysis associated with G6PD deficiency likely shortened RBC lifespan, producing spuriously low HbA1c values. Fructosamine testing was consistent with ongoing hyperglycemia.</p><p><strong>Conclusion: </strong>This case underscores the importance of considering alternative glycemic markers, such as fructosamine or CGM metrics, when discordance exists between HbA1c and clinical or CGM findings. Early recognition of G6PD deficiency in diabetic patients with such unusual presentation is critical to ensure accurate monitoring and to guide patient education on avoiding oxidative stress triggers.</p>","PeriodicalId":9621,"journal":{"name":"Case Reports in Endocrinology","volume":"2026 ","pages":"3927494"},"PeriodicalIF":0.8,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13522717/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148849816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Acute Pulmonary Edema as a Manifestation of Thyroid Crisis From Hydatidiform Mole: A Case Report.","authors":"Thaís Tiemi Yauti, Lin Yan, Fernanda Verza Azevedo, Paula Nina Shiroma, Cleomar Ana de Souza Valentim, Mariana Soares Dalla Mariga Jorgino","doi":"10.1155/crie/3431031","DOIUrl":"10.1155/crie/3431031","url":null,"abstract":"<p><strong>Objective: </strong>To report a clinical case of complete hydatidiform mole (CHM) with significant impact on thyroid function, associated with the development of acute pulmonary edema in the period following uterine evacuation.</p><p><strong>Case report: </strong>A 46-year-old woman sought medical attention due to significant vaginal bleeding, with marked elevation of serum β-hCG (greater than 300,000 mIU/mL), as well as transvaginal ultrasonography with imaging suggestive of HM. After uterine evacuation, the patient developed acute respiratory failure with dyspnea and chest pain, requiring intensive care admission and mechanical ventilation. Thyroid storm was diagnosed based on clinical presentation, laboratory findings, and Burch-Wartofsky criteria (50 points). Additional investigations excluded pulmonary embolism and primary thyroid disease. Removal of the HM resulted in decreased β-hCG titers; however, normalization of serum thyroid hormone levels occurred only after pharmacological treatment.</p><p><strong>Conclusion: </strong>This case highlights the potential progression of hCG-mediated thyrotoxicosis to thyroid crisis after uterine evacuation and emphasizes the importance of early recognition and treatment of severe hyperthyroidism in patients with HM. Early diagnosis and prompt management may help prevent thyroid crisis and cardiopulmonary complications. This case also demonstrates that acute pulmonary edema and transient cardiac dysfunction may occur as severe manifestations of thyroid crisis associated with gestational trophoblastic disease (GTD). Furthermore, close collaboration among obstetric, endocrine, and critical care teams is essential to optimize outcomes in complex presentations.</p>","PeriodicalId":9621,"journal":{"name":"Case Reports in Endocrinology","volume":"2026 ","pages":"3431031"},"PeriodicalIF":0.8,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504243/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148817543","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improvement of Multifactorial Tremor in Klinefelter Syndrome With Testosterone Replacement Therapy.","authors":"Jared Houssarini, Albert Hsieh, Samantha Hocking","doi":"10.1155/crie/8988814","DOIUrl":"10.1155/crie/8988814","url":null,"abstract":"<p><p>A man in his 50s with long-standing learning difficulties and schizophrenia currently treated with clozapine presented with gynaecomastia and a new right testicular mass. He was noted to have a severe tremor interfering with activities of daily living treated with combination levodopa + benserazide, primidone and topiramate. Investigations revealed elevated prolactin, gonadotropins, sex hormone binding globulin, total testosterone and oestradiol. Right orchidectomy revealed Leydig cell hyperplasia. Karyotyping diagnosed Klinefelter syndrome. Testosterone replacement therapy (TRT) was commenced, with subsequent marked improvement in his debilitating tremor. Tremor is a potentially disabling complication of Klinefelter syndrome with fewer than 50 cases reported in the literature. The pathophysiology of tremor in Klinefelter syndrome is unclear. Tremor in Klinefelter syndrome is often refractory to anti-tremor medical therapy; however, as reported in this case, testosterone therapy may improve tremor in Klinefelter syndrome. It is rare for TRT to significantly improve tremor as reported in this case.</p>","PeriodicalId":9621,"journal":{"name":"Case Reports in Endocrinology","volume":"2026 ","pages":"8988814"},"PeriodicalIF":0.8,"publicationDate":"2026-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13491383/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148788567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Alemtuzumab-Induced Graves' Disease Complicated by Pretibial Myxoedema: A Case Report.","authors":"Aongus O'Brolchain, Elham Reda","doi":"10.1155/crie/5617569","DOIUrl":"10.1155/crie/5617569","url":null,"abstract":"<p><strong>Background: </strong>Alemtuzumab, a monoclonal antibody targeting CD52, is associated with a high incidence of secondary autoimmune disease, most commonly thyroid dysfunction. Alemtuzumab-induced Graves' disease (AIGD) typically follows a relapsing course and may exhibit atypical or severe phenotypes during immune reconstitution (IR).</p><p><strong>Case presentation: </strong>We report a case of severe thyrotoxicosis following alemtuzumab therapy for multiple sclerosis, complicated by the development of thyroid eye disease (TED) and pretibial myxoedema (PTM). Despite escalation of antithyroid therapy, biochemical and clinical control remained suboptimal. Radioiodine therapy was not pursued due to the presence of established orbitopathy. Given persistent severe disease and extrathyroidal manifestations, definitive management with total thyroidectomy was undertaken.</p><p><strong>Results: </strong>Thyroidectomy resulted in rapid biochemical control of thyrotoxicosis. thyroid-stimulating hormone-receptor antibody (TRAb) remained markedly elevated after thyroidectomy, indicating persistent autoimmune activity despite removal of the thyroid gland.</p><p><strong>Conclusion: </strong>This case highlights an aggressive and uncommon presentation of AIGD characterised by severe thyrotoxicosis, orbitopathy and PTM. Clinicians should recognise the potential for atypical and refractory disease following alemtuzumab therapy. In selected cases, early consideration of definitive therapy is warranted, particularly when radioiodine is considered unsuitable.</p>","PeriodicalId":9621,"journal":{"name":"Case Reports in Endocrinology","volume":"2026 ","pages":"5617569"},"PeriodicalIF":0.8,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13439395/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148677147","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Hemizygous <i>ANOS1</i> Variant in a Patient With Kallmann Syndrome and Type 2 Diabetes Mellitus: A Case Report.","authors":"Si Qin, Yindi Zhang, Yanrong Chen, Wei Chen, Yinxing Ni, Jian Zhong","doi":"10.1155/crie/8624241","DOIUrl":"10.1155/crie/8624241","url":null,"abstract":"<p><strong>Introduction: </strong>Kallmann syndrome (KS), a rare genetic disorder, is characterized by congenital hypogonadotropic hypogonadism (CHH) and anosmia or hyposmia.</p><p><strong>Case report: </strong>We report a case of KS with type 2 diabetes mellitus (T2DM) associated with a novel hemizygous missense variant in <i>ANOS1</i> (NM_000216.4; exon 4; c.505G >C;p.(Gly169Arg)). A 33-year-old male presented with persistent hyperglycemia, delayed pubertal development with absent secondary sexual characteristics, and lifelong anosmia. Olfactory testing, magnetic resonance imaging (MRI) of the pituitary region, and a gonadotropin-releasing hormone (GnRH) stimulation test supported a clinical diagnosis of KS. Trio-based exome sequencing (ES) revealed the aforementioned hemizygous variant in <i>ANOS1</i>. Notably, neither parent harbored this variant, supporting a de novo origin, which is consistent with the variant's potential pathogenicity. Multiple sequence alignment showed that Gly169 is highly conserved across species, suggesting it may be functionally important for the protein. Furthermore, a three-dimensional protein model generated using SWISS-MODEL predicted marked conformational changes in the protein attributable to this amino acid substitution at a highly conserved residue, suggesting a potential functional impact. Notably, emerging evidence has linked <i>ANOS1</i> variants to dysregulated glucose metabolism, supporting a potential association with T2DM in this case. For treatment, insulin and oral hypoglycemic agents were used for glycemic control, and a GnRH pump was initiated. At the sixth follow-up visit, the patient had achieved satisfactory glycemic control; however, serum testosterone levels remained low despite GnRH pump therapy, so testosterone replacement therapy was subsequently initiated.</p><p><strong>Conclusions: </strong><i>ANOS1</i> variants are genetically diverse and may contribute to both KS pathogenesis and the development of comorbid T2DM, though further studies are needed to confirm this link. For KS patients, close monitoring of fasting glucose, glycated hemoglobin, and oral glucose tolerance test results is advisable to detect diabetes and prediabetes early.</p>","PeriodicalId":9621,"journal":{"name":"Case Reports in Endocrinology","volume":"2026 ","pages":"8624241"},"PeriodicalIF":0.8,"publicationDate":"2026-07-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13392514/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148577141","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lugol's Iodine as a Key Treatment in Transient Gestational Thyrotoxicosis: A Case Report.","authors":"Mariam Mabrouk, Najla Bchir, Dorra El Guiche, Anaam Ben Chehida, Emna Mraihi, Chadia Zouaoui, Haroun Ouertani","doi":"10.1155/crie/7377427","DOIUrl":"10.1155/crie/7377427","url":null,"abstract":"<p><strong>Introduction: </strong>Transient gestational thyrotoxicosis (TGT) occurs when human chorionic gonadotropin (hCG) directly stimulates the maternal thyroid gland during the first trimester of pregnancy. We report a case of complicated TGT in a young woman who required treatment with Lugol's solution.</p><p><strong>Case presentation: </strong>A 29-year-old pregnant woman, at 10 weeks gestation and with no significant medical history, was referred to the endocrinology department for evaluation of hyperthyroidism. She had been experiencing persistent vomiting, anorexia, fatigue, palpitations, abdominal pain, and unintentional weight loss for 2 weeks. On examination, her heart rate was at 120 bpm, and she exhibited resting tremors, but there were no signs of exophthalmos or goiter. Laboratory results revealed a free T4 level 2.2 times above the upper limit of the normal range, with a thyroid-stimulating hormone (TSH) level of 0.01 mUI/L. Tests for thyroid receptor antibodies, thyroid peroxidase antibodies, and anti-thyroglobulin antibodies were negative. A cervical ultrasound with Doppler showed a normal-sized thyroid gland without hypervascularity or nodules, confirming the diagnosis of TGT.Additionally, liver enzyme abnormalities were observed, with ASAT elevated 4.84 times and ALAT 3.42 times the normal limit. Also, acute pancreatitis was diagnosed, as evidenced by a lipase level three times above the upper limit of normal. Given the contraindications for antithyroid drugs (ATDs) and glucocorticoids, treatment was initiated with Lugol's iodine 5% (five drops three times daily) and propranolol (60 mg/day) for 2 weeks. Symptoms of thyrotoxicosis resolved, free T4 returned to normal levels, and liver enzymes normalized.</p><p><strong>Conclusion: </strong>This case highlights the interesting role of Lugol's iodine as a short-term and effective therapeutic option in selected cases of TGT.</p>","PeriodicalId":9621,"journal":{"name":"Case Reports in Endocrinology","volume":"2026 ","pages":"7377427"},"PeriodicalIF":0.8,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13373524/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Proinsulinoma Unmasked by Intermittent Fasting: A Case of Endogenous Proinsulinaemic Hypoglycaemia.","authors":"Aongus O'Brolchain, Gabin Soosaipillai, Sooraj Pillai, Saima Amer","doi":"10.1155/crie/8047572","DOIUrl":"10.1155/crie/8047572","url":null,"abstract":"<p><p>We report a 45-year-old man with recurrent fasting and post-prandial hypoglycaemia due to a proinsulin (PI)-secreting pancreatic neuroendocrine tumour (NET). During a supervised fast, plasma glucose fell to 1.8 mmol/L with detectable but low insulin (0.6 μU/L) and C-peptide (range 0.3-0.6 nmol/L). These concentrations did not meet diagnostic thresholds for endogenous hyperinsulinaemia proposed by the Endocrine Society, The North American Neuroendocrine Tumor Society (NANETS), or European Neuroendocrine Tumor Society (ENETS). In contrast, PI was markedly elevated at 33 pmol/L, exceeding all guideline cut-offs (≥5 pmol/L) and establishing PI-mediated hypoglycaemia. Cross-sectional imaging demonstrated a 16-mm arterially enhancing lesion in the pancreatic body, with intense somatostatin receptor expression on DOTATATE PET (SUVmax 18.0) and no evidence of metastatic disease. Histopathology confirmed a Grade 1 pancreatic NET, consistent with a localised proinsulinoma. This case highlights a diagnostic pitfall associated with contemporary insulin immunoassays, which have limited cross-reactivity with PI and may yield deceptively low insulin levels despite clinically significant endogenous hyperinsulinism. Routine measurement of PI during fasting evaluation is essential, particularly when insulin or C-peptide results appear discordant with the clinical phenotype, to avoid delayed diagnosis and facilitate timely curative intervention.</p>","PeriodicalId":9621,"journal":{"name":"Case Reports in Endocrinology","volume":"2026 ","pages":"8047572"},"PeriodicalIF":0.8,"publicationDate":"2026-07-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13374107/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148469182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ectopic ACTH Production in Medullary Thyroid Carcinoma-A Study of Two Cases.","authors":"Robert Bränström, Fredric Hedberg, Monique Huisman, Maria Petersson, Camilla Jerning, Ivan Shabo, David J M Goldstein, Martin Larsson, C Christofer Juhlin","doi":"10.1155/crie/8889322","DOIUrl":"10.1155/crie/8889322","url":null,"abstract":"<p><p>Medullary thyroid carcinoma (MTC) is a rare neuroendocrine tumor originating from thyroid parafollicular C-cells, accounting for 1-2% of all thyroid cancers. An exceedingly rare manifestation of MTC is ectopic adrenocorticotropic hormone (ACTH) production, causing Cushing's syndrome and complicating management. This report presents two cases of MTC with ectopic ACTH production, highlighting diagnostic challenges, therapeutic strategies, and clinical outcomes. A comprehensive literature review on this rare paraneoplastic syndrome is included and supplements the case findings. Case 1 involves a 49-year-old man presenting with abdominal pain, weight loss, and pulmonary nodules, diagnosed with MTC and ectopic ACTH-related Cushing's syndrome. Surgical resection and targeted therapy with selpercatinib improved cortisol levels but were complicated by adverse drug reactions. Case 2 details a 65-year-old woman with severe hypercortisolism and locally advanced MTC. Selpercatinib successfully reduced hormone levels and achieved partial tumor regression. Both cases underscore the critical role of tyrosine kinase inhibitors (TKIs) in controlling tumor progression, and paraneoplastic hormone production is exemplified in both cases, as treatment initiation was followed by a biochemical response with declining levels of ACTH, cortisol, and calcitonin. Ectopic ACTH production in MTC is a rare but clinically significant entity associated with aggressive disease. Early recognition, comprehensive biochemical and imaging evaluations, and a multidisciplinary approach are pivotal for optimal management. The advent of targeted therapies, such as selpercatinib, has transformed the therapeutic landscape, offering improved control of both tumor burden and hormone excess. This report highlights the importance of integrating genomic insights and precision medicine in addressing these complex cases.</p>","PeriodicalId":9621,"journal":{"name":"Case Reports in Endocrinology","volume":"2026 ","pages":"8889322"},"PeriodicalIF":0.8,"publicationDate":"2026-07-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13339059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148403752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Autoinfarction of the Parathyroid Gland: An Unusual Presentation of Primary Hyperparathyroidism.","authors":"Jaskaran Batra, Tanya Aggarwal, Akshaya Ramachandran, Amy Neumeister, Laura Graeff-Armas","doi":"10.1155/crie/2683073","DOIUrl":"10.1155/crie/2683073","url":null,"abstract":"<p><strong>Background: </strong>Primary hyperparathyroidism (PHPT) is commonly caused by a parathyroid adenoma and typically presents with hypercalcemia and elevated parathyroid hormone (PTH) levels. Spontaneous infarction of parathyroid adenoma is a rare phenomenon that can lead to spontaneous resolution of hypercalcemia.</p><p><strong>Case presentation: </strong>We report the case of a 48-year-old male with a history of PHPT diagnosed 7 years prior and was lost to follow up, who presented with left-sided facial and finger paresthesia. Initial labs revealed low ionized calcium with a normal PTH level. Imaging identified a heterogeneous mass adjacent to the left thyroid lobe. Biopsy confirmed infarcted parathyroid adenoma. The patient's prior PHPT had spontaneously resolved, but he now presented with symptomatic hypocalcemia likely due to adenoma infarction.</p><p><strong>Discussion: </strong>Spontaneous infarction of a parathyroid adenoma is an uncommon cause of remission in PHPT. While transient remission of hypercalcemia has been documented, long-term outcomes remain variable. Our case is unusual as the patient presented with symptomatic hypocalcemia years after initial diagnosis.</p><p><strong>Conclusion: </strong>Autoinfarction of parathyroid adenomas can result in spontaneous remission of PHPT but may also lead to unexpected complications such as hypocalcemia. Ongoing follow-up is essential to monitor both recurrence of hypercalcemia and the development of hypocalcemia.</p>","PeriodicalId":9621,"journal":{"name":"Case Reports in Endocrinology","volume":"2026 ","pages":"2683073"},"PeriodicalIF":0.8,"publicationDate":"2026-06-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13315443/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148359748","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adrenal Tuberculosis Presenting as Adrenal Crisis: A Rare Presentation of Common Disease.","authors":"Berhanu Kelemework Fenta, Akberet Semere Yihdego, Bereket Kusse Kurtaile, Worku Ketema","doi":"10.1155/crie/9086526","DOIUrl":"10.1155/crie/9086526","url":null,"abstract":"<p><p>We report a case of a 45-year-old man presenting with hypotension, hyponatremia, hyperkalemia, hypoglycemia and diffuse hyperpigmentation. Monitoring serum cortisol was 0.5 μg/dL, and the computerized tomography (CT) scan showed bilateral adrenal enlargement, consistent with primarily adrenal insufficiency (AI) likely due to adrenal tuberculosis (TB). There was no active pulmonary TB. This case underscores the diagnostic delay and management challenges of TB-related AI in resource-limited settings. Even today, clinicians should remain aware of AI due to TB in resource-limited settings.</p>","PeriodicalId":9621,"journal":{"name":"Case Reports in Endocrinology","volume":"2026 ","pages":"9086526"},"PeriodicalIF":0.8,"publicationDate":"2026-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13311310/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148350911","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}