Acf. Dovalle et al., RECOVERY OF ADRENAL-FUNCTION AFTER TREATMENT OF PARACOCCIDIOIDOMYCOSIS, The American journal of tropical medicine and hygiene, 48(5), 1993, pp. 626-629
Citations number
15
Categorie Soggetti
Public, Environmental & Occupation Heath","Tropical Medicine
In endemic areas, the systemic mycosis paracoccidioidomycosis (PCM) is
the most frequent etiology of Addison's disease. Paracoccidioides bra
siliensis, the causative agent of PCM, exhibits a high tropism for the
adrenal glands, which results in a low hormone reserve and in more se
vere cases, in symptoms of primary adrenal insufficiency. In these cas
es, the hormone deficit is usually treated with replacement corticoid
therapy for the rest of the patient's life. Recently, we identified th
ree patients with disseminated PCM who had adrenal insufficiency; one
of them had Addison's disease. All showed complete recovery of adrenal
function after a 1-2-year period of specific therapy with ketoconazol
e or sulfonamides. Plasma cortisol levels were determined by radioimmu
noassay of baseline blood samples, as well as those taken after the ra
pid stimulation test with synthetic adrenocorticotrophic hormone, and
before and after the antifungal therapy.