Hypoadrenal syndrome in a patient with amyloidosis secondary to familial mediterranean fever

Amyloidosis is a common complication of poorly controlled familial Mediterranean fever (FMF). A variety of organs including kidneys, heart, liver, thyroid and adrenal glands may be clinically affected. However, involvement of adrenal glands leading to significant inefficiency is rarely seen in FMF patients with amyloidosis. The impairment of neuroendocrine immune system in FMF together with proteinuria in renal amyloidosis is a challenge while interpreting adrenal function tests. Here we present a case report of a 42-year-old man with FMF and renal failure due to amyloidosis whose disease course was complicated by adrenal insufficiency.

[1]  R. Demirtunç,et al.  Is there a real adrenal axis dysfunction in patients with amyloidosis associated with familial Mediterranean fever? , 2012, Rheumatology International.

[2]  A. Bakkaloğlu,et al.  Neuroendocrine immune system in familial Mediterranean fever. , 2010, The Turkish journal of pediatrics.

[3]  E. Hasanoǧlu,et al.  Acute adrenal crisis mimicking familial Mediterranean fever attack in a renal transplant FMF patient with amyloid goiter , 2010, Rheumatology International.

[4]  John G Lewis,et al.  A case of low cortisol-binding globulin: use of plasma free cortisol in interpretation of hypothalamic-pituitary-adrenal axis tests , 2006, Annals of clinical biochemistry.

[5]  F. Keleştimur,et al.  Adrenal axis functions in patients with familial Mediterranean fever , 2006, Clinical Rheumatology.

[6]  Kelestimur Fahrettin,et al.  Adrenal axis functions in patients with familial Mediterranean fever , 2006, Clinical Rheumatology.

[7]  A. Brennan,et al.  Nephrotic syndrome: cause of an abnormal response to the rapid ACTH stimulation test. , 2004, Nephrology, dialysis, transplantation : official publication of the European Dialysis and Transplant Association - European Renal Association.

[8]  O. Colak,et al.  Early blunted cortisol response to insulin induced hypoglycaemia in familial Mediterranian fever. , 2002, Clinical and experimental rheumatology.

[9]  K. Keven,et al.  Polyglandular endocrine failure in a patient with amyloidosis secondary to familial Mediterranean fever. , 2001, American journal of kidney diseases : the official journal of the National Kidney Foundation.