{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,3]],"date-time":"2026-08-03T22:30:51Z","timestamp":1785796251148,"version":"3.56.0"},"reference-count":10,"publisher":"BMJ","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Reports"],"accepted":{"date-parts":[[2016,11,11]]},"abstract":"<jats:p>A 55-year-old Indian man presented with productive cough and a large left pleural effusion. Pleural fluid culture grew <jats:italic>Mycobacterium tuberculosis<\/jats:italic>, and he was started on antituberculosis therapy. One week later, the patient presented to hospital with drowsiness, dehydration and hypotension. He was transferred to critical care and only improved after starting hydrocortisone and stopping rifampicin. His short synACTHen test subsequently confirmed primary adrenal insufficiency, and a CT of the abdomen showed bilateral adrenal enlargement. Rifampicin is known to accelerate cortisol metabolism. We report the rare case of a rifampicin-induced adrenal crisis as a first presentation of Addison's disease in a patient with tuberculous infiltration of the adrenal glands.<\/jats:p>","DOI":"10.1136\/bcr-2016-216302","type":"journal-article","created":{"date-parts":[[2016,11,29]],"date-time":"2016-11-29T10:41:25Z","timestamp":1480416085000},"page":"bcr2016216302","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":10,"title":["Rifampicin-induced adrenal crisis in a patient with tuberculosis: a therapeutic challenge"],"prefix":"10.1136","volume":"2016","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5351-9581","authenticated-orcid":false,"given":"Nicholas","family":"Denny","sequence":"first","affiliation":[{"name":"Department of Respiratory Medicine, Tameside General Hospital, Ashton-under-Lyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarika","family":"Raghunath","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Tameside General Hospital, Ashton-under-Lyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Praveen","family":"Bhatia","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Tameside General Hospital, Ashton-under-Lyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muntasir","family":"Abdelaziz","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, Tameside General Hospital, Ashton-under-Lyne, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2016,11,29]]},"reference":[{"key":"2025082802533719000_2016.nov29_1.bcr2016216302.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(03)13492-7"},{"key":"2025082802533719000_2016.nov29_1.bcr2016216302.2","doi-asserted-by":"crossref","first-page":"pii: bcr2013010473","DOI":"10.1136\/bcr-2013-010473","article-title":"Addison's disease and its associations","volume":"2013","author":"Puttanna","year":"2013","journal-title":"BMJ Case Rep"},{"key":"2025082802533719000_2016.nov29_1.bcr2016216302.3","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1111\/cen.12865","article-title":"Incidence of adrenal crisis in patients with adrenal insufficiency","volume":"84","author":"Smans","year":"2015","journal-title":"Clin Endocrinol (Oxf)"},{"key":"2025082802533719000_2016.nov29_1.bcr2016216302.4","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.286.6381.1861-a"},{"key":"2025082802533719000_2016.nov29_1.bcr2016216302.5","doi-asserted-by":"publisher","DOI":"10.1016\/0041-3879(89)90069-X"},{"key":"2025082802533719000_2016.nov29_1.bcr2016216302.6","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.48.1974"},{"key":"2025082802533719000_2016.nov29_1.bcr2016216302.7","first-page":"487189","article-title":"Adrenal insufficiency as a cause of acute liver failure: a case report","volume":"2013","author":"Vafaeimanesh","year":"2013","journal-title":"Case Rep in Endo"},{"key":"2025082802533719000_2016.nov29_1.bcr2016216302.8","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2125.1989.tb03516.x"},{"key":"2025082802533719000_2016.nov29_1.bcr2016216302.9","first-page":"127","article-title":"Reversal of subclinical adrenal insufficiency through antituberculosis treatment in TB patients: a longitudinal follow up","volume":"122","author":"Sharma","year":"2005","journal-title":"Indian J Med Res"},{"key":"2025082802533719000_2016.nov29_1.bcr2016216302.10","first-page":"67","article-title":"Evaluation of pseudoadrenal insufficiency in tuberculosis patients","volume":"6","author":"Tabarsi","year":"2007","journal-title":"Tanaffos"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2016-216302","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T09:53:42Z","timestamp":1756374822000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2016-216302"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,11,29]]},"references-count":10,"alternative-id":["10.1136\/bcr-2016-216302"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2016-216302","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,11,29]]}}}