[Skip to Content]
[Skip to Content Landing]
December 19, 1986

Adrenal Insufficiency due to Cryptococcosis

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.

JAMA. 1986;256(23):3247-3249. doi:10.1001/jama.1986.03380230071028

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 With a progressive decrease in the prevalence of this granulomatous process, however, autoimmune disease has superseded tuberculosis as the most frequent cause of primary adrenal insufficiency.1 It is amply documented, nevertheless, that certain fungal diseases such as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