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Tuberculous adrenalitis — SCE Endocrinology MCQ

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ModerateAdrenalTuberculous adrenalitisSCE Endocrinology

A 63-year-old man has bilateral adrenal enlargement and primary adrenal insufficiency. He has fever, night sweats and weight loss. CT chest shows upper-lobe cavitation. What is the most likely cause of adrenal failure?

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Correct answer: A — Tuberculous adrenalitis

Bilateral adrenal enlargement with constitutional symptoms and cavitating lung disease suggests tuberculosis affecting the adrenals. Autoimmune adrenalitis more often causes adrenal atrophy over time. Mineralocorticoid excess disorders do not cause primary adrenal failure.

Reference: NICE NG243; Society for Endocrinology Guidance