{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,10]],"date-time":"2026-10-10T00:11:01Z","timestamp":1791591061423,"version":"4.3.4"},"reference-count":12,"publisher":"BMJ","issue":"3","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,2,18]]},"published-print":{"date-parts":[[2019,3]]},"abstract":"<jats:p>A 58-year-old man was referred to our hospital for darkened skin, general fatigue and weight loss. His adrenocorticotropic hormone and cortisol levels indicated a primary adrenal insufficiency. <jats:sup>18<\/jats:sup>Fluorodeoxyglucose positron emission tomography\/CT showed bilateral enlargement of the adrenal glands, with <jats:sup>18<\/jats:sup>fluorodeoxyglucose accumulation. Loop-mediated isothermal amplification assays of bronchoalveolar lavage fluid were positive for <jats:italic>Mycobacterium tuberculosis<\/jats:italic>. The patient was diagnosed with tuberculous Addison\u2019s disease and treated with antituberculosis agents, including rifampicin. The patient\u2019s fatigue worsened gradually after initiation of rifampicin, and the dosage of hydrocortisone was increased. Serum cortisol level monitoring at 2\u2009hours after administration of hydrocortisone was shown to be clinically useful for determining the optimal dose, especially with concurrent use of rifampicin.<\/jats:p>","DOI":"10.1136\/bcr-2018-228293","type":"journal-article","created":{"date-parts":[[2019,3,14]],"date-time":"2019-03-14T10:57:19Z","timestamp":1552561039000},"page":"e228293","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Tuberculous Addison\u2019s disease with increased hydrocortisone requirements due to administration of rifampicin"],"prefix":"10.1136","volume":"12","author":[{"given":"Kazuhisa","family":"Kusuki","sequence":"first","affiliation":[{"name":"Metabolism and Endocrinology, Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Watanabe","sequence":"additional","affiliation":[{"name":"Metabolism and Endocrinology, Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuzo","family":"Mizuno","sequence":"additional","affiliation":[{"name":"Metabolism and Endocrinology, Kanto Central Hospital of the Mutual Aid Association of Public School Teachers, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,3,14]]},"reference":[{"key":"2025082709592888000_12.3.e228293.1","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.33.602"},{"key":"2025082709592888000_12.3.e228293.2","doi-asserted-by":"crossref","first-page":"765","DOI":"10.1507\/endocrj.EJ16-0242","article-title":"Diagnosis and treatment of adrenal insufficiency including adrenal crisis: a Japan Endocrine Society clinical practice guideline [Opinion]","volume":"63","author":"Yanase","year":"2016","journal-title":"Endocr J"},{"key":"2025082709592888000_12.3.e228293.3","first-page":"742","article-title":"A statistical analysis of five hundred and sixty-six cases and a study of the pathology","volume":"10","author":"Guttman","year":"1930","journal-title":"Arch Pathol"},{"key":"2025082709592888000_12.3.e228293.4","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9343(85)90339-0"},{"key":"2025082709592888000_12.3.e228293.5","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.1998.00409.x"},{"key":"2025082709592888000_12.3.e228293.6","doi-asserted-by":"publisher","DOI":"10.1210\/jc.2015-1710"},{"key":"2025082709592888000_12.3.e228293.7","doi-asserted-by":"crossref","first-page":"1843","DOI":"10.2169\/internalmedicine.56.7976","article-title":"Addison\u2019s Disease caused by tuberculosis with atypical hyperpigmentation and active pulmonary tuberculosis","volume":"56","author":"Namikawa","year":"2017","journal-title":"Intern Med"},{"key":"2025082709592888000_12.3.e228293.8","doi-asserted-by":"crossref","first-page":"239","DOI":"10.1007\/s10156-009-0690-Z","article-title":"Addison\u2019s disease due to tuberculosis that required differentiation from SIADH","volume":"15","author":"Kinjo","year":"2009","journal-title":"J Infect Chemother"},{"key":"2025082709592888000_12.3.e228293.9","doi-asserted-by":"publisher","DOI":"10.1016\/0041-3879(89)90069-X"},{"key":"2025082709592888000_12.3.e228293.10","doi-asserted-by":"publisher","DOI":"10.2169\/internalmedicine.48.1974"},{"key":"2025082709592888000_12.3.e228293.11","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.286.6381.1861"},{"key":"2025082709592888000_12.3.e228293.12","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0135975","article-title":"Usefulness of time-point serum cortisol and ACTH measurements for the adjustment of glucocorticoid replacement in adrenal insufficiency","volume":"10","author":"Rousseau","year":"2015","journal-title":"PLoS One"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2018-228293","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T16:59:40Z","timestamp":1756313980000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2018-228293"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3]]},"references-count":12,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,3,14]]},"published-print":{"date-parts":[[2019,3]]}},"alternative-id":["10.1136\/bcr-2018-228293"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2018-228293","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,3]]}}}