Cytomegalovirus (CMV) Adrenalitis Leading to Adrenal Insufficiency in a Patient with AIDS, Disguised by Concomitant Corticosteroid Administration: A Case Report

The adrenal gland is the most commonly involved endocrine organ in autopsy studies of patients who die of Acquired Immunodeficiency Syndrome (AIDS) (Welch 1984). The most common finding at autopsy is the presence of intranuclear or intracytoplasmic inclusion bodies in enlarged adrenal cells, indicative of Cytomegalovirus (CMV) adrenalitis (Eledrisi & Verghese 2001). Despite the frequent involvement of the adrenal glands with CMV, overt adrenal insufficiency is uncommon in these patients. This is because at least 80% of the gland must be destroyed before adrenal insufficiency becomes clinically apparent and requires treatment (Hofbauer & Heufelder, 1996; Grinspoon & Bilezikian, 1992). We report a case where the diagnosis of hypoadrenalism was further delayed because Abstract