Adrenal pathology in the acquired immune deficiency syndrome.

Important note: Information in this article was accurate in 1986. The state of the art may have changed since the publication date.

Adrenal pathology in the acquired immune deficiency syndrome.

Am J Clin Pathol. 1985 Nov;84(5):594-7. Unique Identifier : AIDSLINE MED/86047696
Glasgow BJ; Steinsapir KD; Anders K; Layfield LJ

Abstract: Adrenal pathology was examined in 41 autopsied patients with the acquired immune deficiency syndrome. This represents the largest series and the first study with quantitation of adrenal cortical necrosis. In 32 cases clinical data were analyzed for features of adrenal insufficiency. Common clinical findings included vomiting, diarrhea, fever, hypotension, and hyponatremia. None of the 32 patients showed characteristic skin hyperpigmentation. Two patients were suspected premortem to have adrenal insufficiency. In one of these patients, adrenocorticotrophic hormone (ACTH) stimulation resulted in an adequate rise in plasma cortisol values. In the other patient, the baseline plasma cortisol value was elevated and failed to rise significantly after ACTH stimulation. Pathologic findings included widespread lipid depletion, infection by cryptococcus, and acid-fast organisms consistent with Mycobacterium avium-intracellulare, involvement by Kaposi's sarcoma, and necrotizing adrenalitis due to cytomegalovirus (CMV). A point-counting method was used to quantitate adrenal cortical and medullary necrosis. Necrosis due to CMV was greater in the medulla than the cortex. The maximum amount of adrenal cortical necrosis in any case was 70%. The degree of cortical necrosis was less than that usually associated with adrenal insufficiency.

Keywords: Acquired Immunodeficiency Syndrome/MICROBIOLOGY/*PATHOLOGY Adrenal Cortex/PATHOLOGY Adrenal Gland Hypofunction/COMPLICATIONS Adrenal Glands/MICROBIOLOGY/*PATHOLOGY Adrenal Medulla/PATHOLOGY Adult Autopsy Cryptococcus neoformans/ISOLATION & PURIF Human Male Middle Age Mycobacterium avium/ISOLATION & PURIF JOURNAL ARTICLE

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