Successful treatment with ganciclovir of a HIV endstage patient with adrenal insufficiency.
We report on a 31-year-old AIDS patient who presented with rapid progressive fatigue, weakness, weight loss and hyperpigmentation. Endoscopy showed an ulcerous CMV gastritis with the histological hallmarks of this disease. In addition, laboratory tests revealed the constellation of an adrenal insufficiency with low plasma levels of sodium and increased levels of potassium and ACTH. After initiation of ganciclovir treatment, the CMV gastritis healed and the electrolyte abnormalities were resolved within 2 weeks. We assume that a CMV adrenalitis was treated in a reversible stage. The literature on CMV adrenalitis is reviewed to support this conclusion.
Mühlhöfer
A
A
Medizinische Poliklinik, Klinikum Innenstadt, Ludwig-Maximilians-University Munich, Pettenkoferstr. 8a, Munich D-80336, Germany. 3315@compuserve.com
Jung
C
C
Gross
M
M
D017088:AIDS-Related Opportunistic Infections / Q000097:blood / Q000188:drug therapy*; D000307:Adrenal Gland Diseases / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000821:virology; D000324:Adrenocorticotropic Hormone / Q000097:blood; D000328:Adult; D000450:Aldosterone / Q000097:blood; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D003586:Cytomegalovirus Infections / Q000097:blood / Q000188:drug therapy*; D004381:Duodenal Ulcer / Q000188:drug therapy / Q000821:virology; D015774:Ganciclovir / Q000627:therapeutic use*; D005756:Gastritis / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000627:therapeutic use; D007010:Hyponatremia / Q000188:drug therapy / Q000209:etiology; D008297:Male; D013276:Stomach Ulcer / Q000188:drug therapy / Q000821:virology
D019380:Anti-HIV Agents; D000450:Aldosterone; D000324:Adrenocorticotropic Hormone; D015774:Ganciclovir; D006854:Hydrocortisone