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Bharat Shah, MB, BS; Harris C. Taylor, MD; Indira Pillay, MB, BS; Moonja Chung-Park, MD; Robert Dobrinich, MD

JAMA. 1986;256(23):3247-3249.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

UNTIL the mid-1930s, tuberculosis had traditionally been considered to be the most frequent cause of primary adrenal insufficiency. With a progressive decrease in the prevalence of this granulomatous process, however, autoimmune disease has superseded tuberculosis as the most frequent cause of primary adrenal insufficiency.¹ It is amply documented, nevertheless, that certain fungal diseases such as histoplasmosis as well as neoplasms may destroy sufficient adrenal tissue to produce the signs and symptoms of Addison's disease.^2-4 It is our purpose herein to point out the less well-known fact that other fungal diseases, by means of massive destruction of the adrenal glands, may likewise produce adrenal insufficiency. Specifically, we detail what to the best of our knowledge is the second reported, antemortem biochemically and histopathologically confirmed documentation of cryptococcal-induced adrenal cortical insufficiency. We likewise point out the value of computed tomographic (CT) scanning of the adrenal glands to assist in the . . . [Full Text PDF of this Article]

Author Affiliations
From the Division of Endocrinology (Drs Shah and Taylor) and the Department of Pathology (Dr Pillay), Lutheran Medical Center, and the Case Western Reserve University School of Medicine (Drs Taylor, Pillay, Chung-Park, and Dobrinich), Cleveland; and the Department of Pathology (Dr Chung-Park) and the Division of Infectious Disease (Dr Dobrinich), Cleveland Metropolitan General Hospital.

Footnotes
Reprint requests to Division of Endocrinology, Lutheran Medical Center, 2609 Franklin Blvd, Cleveland, OH 44113 (Dr Taylor).

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