Clinical Characteristics of Nine Case of Adrenal Tuberculosis and Literature Review

Background To examine the clinical features of adrenal tuberculosis to improve clinicians' diagnostic accuracy and treatment strategies. Methods We report on nine patients diagnosed with adrenal tuberculosis at the Shanghai Public Health Clinical Center between January 2014 and June 2024. Additionally, we reviewed 206 cases from 60 published reports. We comparatively analyzed the clinical characteristics, laboratory findings, and treatment outcomes. Results Among the nine patients in this hospital, All nine patients underwent anti-tuberculosis therapy, and three also received corticosteroid treatment. Follow-up outcomes showed that four patients were lost to follow-up, while five were cured. Of the 206 cases reported in the literature, Among 160 cases detailing treatment regimens, 152 cases (95%) underwent anti-tuberculosis therapy, and eight were treated with adrenalectomy alone. Cortisol replacement therapy was administered to 106 cases (66%). Prognostic data from 119 cases reported that 40 patients (34%) were cured and 79 (66%) improved. Conclusion Adrenal tuberculosis predominantly affects both adrenal glands. Pathological findings are granulomatous inflammation and caseous necrosis. The diagnosis of adrenal tuberculosis relies on evidence of adrenal cortical insufficiency, extra-adrenal tuberculosis, laboratory confirmation of tuberculosis infection, characteristic imaging features, pathological examination, and diagnostic anti-tuberculosis therapy.