The coroner said cause of death was given as Addisonian crisis caused by autoimmune adrenalitis
, contributed to by gastroenteritis.
In these cases, the HPA axis issue might mainly be autoimmune adrenalitis
. And, that condition is simply a mild version of what causes 70% of true Addison's disease.
(1) Severe infections may precipitate fulminant meningococcemia (hemorrhagic adrenalitis
) that may result in fatalities.
In their attempt to augment the immune response, PD-1 inhibitors can breach immunologic tolerance by upregulating autoreactive T-cells causing immune mediated reactions such as rash, pneumonitis, colitis, thyroiditis, hepatitis, nephritis, uveitis, adrenalitis
, facial nerve paresis, hypophysitis, aseptic meningitis, and fulminant diabetes .
Evaluation of primary adrenal insufficiency secondary to tuberculous adrenalitis
with computed tomography and magnetic resonance imaging: Current status.
The most common cause of primary AI in children is congenital adrenal hyperplasia (CAH) which accounts for 70% of pediatric patients with primary AI, whereas autoimmune adrenalitis
(Addison's disease) accounts for up to 15% of cases .
Causes of primary adrenal insufficiency include autoimmune adrenalitis
, infections such as tuberculosis, disseminated fungal infections, human immunodeficiency virus, hemorrhagic infarction, or metastatic cancerous infiltration of the adrenal glands, and drugs.
Some of the side effects described in the literature are immune-mediated rash, pneumonitis, colitis, thyroiditis, hepatitis, nephritis, uveitis, adrenalitis
, facial nerve paresis, hypophysitis, aseptic meningitis, and fulminant diabetes (FD).
Since autoimmune adrenalitis
is the most common cause of primary adrenal insufficiency, the presence of other autoimmune disorders which may require glucocorticoid therapy must be taken into consideration [1, 2].
Muhtelif kanatlilarda yapilan deneysel calismalarda, histolojik olarak nekrotik hepatit ve splenitis, nefrit, pnomoni, nonsuppuratif ensefalitis, tiflitis, kolitis, adrenalitis
, ozefagitis ve midede nekrotik yangi goruldugu rapor edilmistir (4, 13, 16, 17, 20, 27, 42, 46, 47).
Fourteen of the patients with adrenal insufficiency had HIV-associated adrenalitis
, and 2 had disseminated tuberculosis.
While in developed countries the leading etiology of primary AI is autoimmune disease, tuberculosis associated adrenalitis
remains an important cause in developing countries [4, 5].