title: Sarcoidosis Presenting Addison's Disease.
abstract: We herein describe a second Japanese case of sarcoidosis presenting Addison's disease. A 52-year-old man was diagnosed with sarcoidosis based on clinical and laboratory findings, including bilateral hilar lymphadenopathy and elevated levels of serum angiotensin-converting enzyme and lysozyme, as well as the presence of noncaseating epithelioid granulomas. The patient also exhibited general fatigue, pigmentation, weight loss, hypotension and hyponatremia, suggestive of chronic adrenocortical insufficiency. An endocrine examination confirmed primary adrenocortical insufficiency. This case suggests the direct involvement of sarcoid granuloma in the adrenal glands.
authors.affiliation: Research Center for Allergy and Clinical Immunology, Asahi General Hospital, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Takahashi
authors.forename: Shin-Ichiro
authors.initials: S
authors.lastname: Kagami
authors.forename: Hirotoshi
authors.initials: H
authors.lastname: Kawashima
authors.forename: Daisuke
authors.initials: D
authors.lastname: Kashiwakuma
authors.forename: Yoshio
authors.initials: Y
authors.lastname: Suzuki
authors.forename: Itsuo
authors.initials: I
authors.lastname: Iwamoto
mesh_terms: D000224:Addison Disease / Q000175:diagnosis*; D000311:Adrenal Glands / Q000473:pathology; D003937:Diagnosis, Differential; D005221:Fatigue / Q000503:physiopathology; D006099:Granuloma / Q000473:pathology; D006801:Humans; D007010:Hyponatremia / Q000473:pathology; D008206:Lymphatic Diseases / Q000473:pathology; D008297:Male; D008875:Middle Aged; D007703:Peptidyl-Dipeptidase A / Q000032:analysis; D012507:Sarcoidosis / Q000175:diagnosis* / Q000473:pathology* / Q000503:physiopathology*
chemical_list: D007703:Peptidyl-Dipeptidase A