{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,27]],"date-time":"2026-06-27T08:38:15Z","timestamp":1782549495061,"version":"3.54.5"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2022,10,23]],"date-time":"2022-10-23T00:00:00Z","timestamp":1666483200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2022,10,23]],"date-time":"2022-10-23T00:00:00Z","timestamp":1666483200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Endocr Disord"],"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Addison\u2019s disease is primary adrenal dysfunction and is characterized by decrease of cortisol level and increase of adrenocorticotropic hormone (ACTH) level. It is known that infection is one of main causes of Addison\u2019s disease. Among various infections, tuberculous infection accounts for the majority of them. Recently the number of subjects with non-tuberculous mycobacterial infection has been increased, and the infection can also bring about Addison\u2019s disease.<jats:italic>Mycobacterium avium<\/jats:italic>complex (MAC) pulmonary disease accounts for the majority of non-tuberculous mycobacterial infection.<\/jats:p><\/jats:sec><jats:sec><jats:title>Case presentation<\/jats:title><jats:p>An 83-year-old female was suspected of having adrenal failure in our outpatient care and hospitalized in our institution. There was pigmentation in her face, hands and legs, especially in auricle and nail beds in her hands and legs. In rapid ACTH load test (0.25\u2009mg of 1\u201324 ACTH), cortisol level was not increased at all. An abdominal computed tomography (CT) showed swelling of both adrenal glands accompanied by calcification. QuantiFERON test was negative and<jats:italic>mycobacterium tuberculosis<\/jats:italic>complex was negative in PCR test using bronchial lung lavage fluid. These data ruled out the possibility of adrenal tuberculosis. It is known that MAC pulmonary disease accounts for the majority of non-tuberculous mycobacterial infection. In this subject, however, anti-MAC antibody was negative and MAC-related bacteria were not detected in PCR test using bronchial lung lavage fluid. These data ruled out the possibility of MAC pulmonary disease.<jats:italic>Mycobacterium abscessus<\/jats:italic>(Mab) was positive in bronchial lung lavage fluid culture. Based on these data, we diagnosed this subject with Addison\u2019s disease triggered by infection with<jats:italic>mycobacterium abscessus<\/jats:italic>, but not by adrenal tuberculous or MAC pulmonary disease. Decreased sodium level and increased eosinophil number were normalized and appetite loss was markedly mitigated after starting hydrocortisone therapy. A chest CT which was taken about 6\u2009months later showed drastic reduction of consolidation in the upper lobe of the left lung although calcification in the adrenal gland was still observed.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>We should bear in mind the possibility of Addison\u2019s disease triggered by another type of infection rather than adrenal tuberculosis or MAC pulmonary disease.<\/jats:p><\/jats:sec>","DOI":"10.1186\/s12902-022-01178-1","type":"journal-article","created":{"date-parts":[[2022,10,23]],"date-time":"2022-10-23T21:03:19Z","timestamp":1666558999000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":2,"title":["Addison\u2019s disease triggered by infection with mycobacterium abscessus, but not by adrenal tuberculosis or MAC pulmonary disease, in a subject with type 2 diabetes mellitus: case report"],"prefix":"10.1186","volume":"22","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7898-1943","authenticated-orcid":false,"given":"Hideaki","family":"Kaneto","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fuminori","family":"Tatsumi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mana","family":"Ohnishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuichiro","family":"Iwamoto","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yukino","family":"Katakura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masashi","family":"Shimoda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhei","family":"Nakanishi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kohei","family":"Kaku","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tomoatsu","family":"Mune","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2022,10,23]]},"reference":[{"key":"1178_CR1","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1016\/j.ejrad.2006.12.012","volume":"62","author":"E-S Ma","year":"2007","unstructured":"Ma E-S, Yang ZG, Li Y, Guo YK, Deng YP, Zhang XC. Tuberculous Addison's disease: morphological and quantitative evaluation with multidetector-row CT. Eur J Radiol. 2007;62:352\u20138.","journal-title":"Eur J Radiol"},{"issue":"214","key":"1178_CR2","doi-asserted-by":"publisher","first-page":"49","DOI":"10.1513\/AnnalsATS.201607-573OC","volume":"2017","author":"K Morimoto","year":"2017","unstructured":"Morimoto K, Hasegawa N, Izumi K, Namkoong H, Uchimura K, Yoshiyama T, et al. A laboratory-based analysis of Nontuberculous mycobacterial lung disease in Japan from 2012 to 2013. Ann Am Thorac Soc. 2017;2017(214):49\u201356.","journal-title":"Ann Am Thorac Soc"},{"key":"1178_CR3","doi-asserted-by":"publisher","first-page":"367","DOI":"10.1164\/rccm.200604-571ST","volume":"175","author":"DE Griffith","year":"2007","unstructured":"Griffith DE, Aksamit T, Brown-Elliott BA, Catanzaro A, Daley C, Gordin F, et al. An official ATS\/IDSA statement: diagnosis, treatment, and prevention of Nontuberculous mycobacterial diseases. Am J Respir Crit Care Med. 2007;175:367\u2013416.","journal-title":"Am J Respir Crit Care Med"},{"key":"1178_CR4","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1513\/AnnalsATS.201303-067OC","volume":"11","author":"K Morimoto","year":"2014","unstructured":"Morimoto K, Iwai K, Uchimura K, Okumura M, Yoshiyama T, Yoshimori K, et al. A steady increase in nontuberculous mycobacteriosis mortality and estimated prevalence in Japan. Ann Am Thorac Soc. 2014;11:1\u20138.","journal-title":"Ann Am Thorac Soc"},{"key":"1178_CR5","doi-asserted-by":"publisher","first-page":"e0128304","DOI":"10.1371\/journal.pone.0128304","volume":"10","author":"S Ide","year":"2015","unstructured":"Ide S, Nakamura S, Yamamoto Y, Kohno Y, Fukuda Y, Ikeda H, et al. Epidemiology and clinical features of pulmonary Nontuberculous Mycobacteriosis in Nagasaki, Japan. PLoS One. 2015;10:e0128304.","journal-title":"PLoS One"},{"key":"1178_CR6","doi-asserted-by":"publisher","first-page":"251","DOI":"10.1128\/JCM.01327-13","volume":"52","author":"K Nakanaga","year":"2014","unstructured":"Nakanaga K, Sekizuka T, Fukano H, Sakakibara Y, Takeuchi F, Wada S, et al. Discrimination of mycobacterium abscessus subsp. massiliense from mycobacterium abscessus subsp. abscessus in clinical isolates by multiplex PCR. J Clin Microbiol. 2014;52:251\u20139.","journal-title":"J Clin Microbiol"},{"key":"1178_CR7","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1128\/JCM.01249-13","volume":"52","author":"K Ruger","year":"2014","unstructured":"Ruger K, Hampel A, Billig S, Rucker N, Suerbaum S, Bang F-C. Characterization of rough and smooth morphotypes of mycobacterium abscessus isolates from clinical specimens. J Clin Microbiol. 2014;52:244\u201350.","journal-title":"J Clin Microbiol"},{"key":"1178_CR8","doi-asserted-by":"publisher","first-page":"e235857","DOI":"10.1136\/bcr-2020-235857","volume":"13","author":"K Bala","year":"2020","unstructured":"Bala K, Kumari S, Guleria R, Singh U. Recurrent bilateral breast abscess due to mycobacterium abscessus in an immune-competent woman. BMJ Case Rep. 2020;13:e235857.","journal-title":"BMJ Case Rep"},{"key":"1178_CR9","doi-asserted-by":"crossref","first-page":"93","DOI":"10.4103\/ijmy.ijmy_22_21","volume":"10","author":"R Gopalaswamy","year":"2021","unstructured":"Gopalaswamy R, Padmapriyadarsini C, Sekar K, Vijayaragavan V, Bhavani PK, Lokanathan LM, et al. Pulmonary mycobacterium abscessus and response to treatment in an outpatient setting: case series. Int J Mycobacteriol. 2021;10:93\u20137.","journal-title":"Int J Mycobacteriol"},{"key":"1178_CR10","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1183\/23120541.00191-2020","volume":"7","author":"A Cheng","year":"2021","unstructured":"Cheng A, Sun HY, Tsai YT, Lu PL, Lee SS, Lee YT, et al. Longitudinal non-cystic fibrosis trends of pulmonary mycobacterium abscessus disease from 2010 to 2017: spread of the \"globally successful clone\" in Asia. ERJ Open Res. 2021;7:1\u201311.","journal-title":"ERJ Open Res"},{"key":"1178_CR11","doi-asserted-by":"publisher","first-page":"726","DOI":"10.11150\/kansenshogakuzasshi.87.726","volume":"87","author":"H Nagano","year":"2013","unstructured":"Nagano H, Amitani R, Okamoto N, Yoshida M, Taki M, Hanaoka K, et al. A clinical study of pulmonary mycobacterium abscessus infection. Kansenshoshi. 2013;87:726\u201331.","journal-title":"Kansenshoshi"},{"key":"1178_CR12","first-page":"587","volume":"92","author":"T Numata","year":"2017","unstructured":"Numata T, Inaki S, Kojima J, Ishikawa T, Hara H, Nakayama K, et al. A retrospective study of mycobacterium abscessus. Kekkaku. 2017;92:587\u201393.","journal-title":"Kekkaku"},{"key":"1178_CR13","doi-asserted-by":"publisher","first-page":"e29148","DOI":"10.1371\/journal.pone.0029148","volume":"6","author":"LB Davidson","year":"2011","unstructured":"Davidson LB, Nessar R, Kempaiah P, Perkins DJ, Byrd TF. Mycobacterium abscessus glycopeptidolipid prevents respiratory epithelial TLR2 signaling as measured by H\u03b2D2 gene expression and IL-8 release. PLoS One. 2011;6:e29148.","journal-title":"PLoS One"},{"key":"1178_CR14","doi-asserted-by":"publisher","first-page":"3556","DOI":"10.1128\/JCM.01175-12","volume":"50","author":"T Harada","year":"2012","unstructured":"Harada T, Akiyama Y, Kurashima A, Nagai H, Tsuyuguchi K, Fujii T, et al. Clinical and microbiological differences between mycobacterium abscessus and Mycobacterium massiliense lung diseases. J Clin Microbiol. 2012;50:3556\u201361.","journal-title":"J Clin Microbiol"}],"container-title":["BMC Endocrine Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-022-01178-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12902-022-01178-1\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12902-022-01178-1.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,11,29]],"date-time":"2023-11-29T12:07:21Z","timestamp":1701259641000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcendocrdisord.biomedcentral.com\/articles\/10.1186\/s12902-022-01178-1"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,10,23]]},"references-count":14,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2022,12]]}},"alternative-id":["1178"],"URL":"https:\/\/doi.org\/10.1186\/s12902-022-01178-1","relation":{},"ISSN":["1472-6823"],"issn-type":[{"value":"1472-6823","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,10,23]]},"assertion":[{"value":"12 April 2021","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"16 October 2022","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 October 2022","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for publication of this case report and any accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"We do not have any potential conflicts of interest relevant to this article.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"257"}}