RECOVERY OF ADRENAL-FUNCTION AFTER TREATMENT OF PARACOCCIDIOIDOMYCOSIS

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.