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Case Reports in Endocrinology
Volume 2017, Article ID 1543149, 4 pages
https://doi.org/10.1155/2017/1543149
Case Report

Normalization of Bilateral Adrenal Gland Enlargement after Treatment for Cryptococcosis

1Department of Endocrinology and Diabetes, Nagoya University Graduate School of Medicine, Nagoya 466-8550, Japan
2Research Center of Health, Physical Fitness and Sports, Nagoya University, Nagoya 464-8601, Japan

Correspondence should be addressed to Shintaro Iwama; pj.ca.u-ayogan.dem@amawis

Received 15 January 2017; Revised 10 March 2017; Accepted 14 March 2017; Published 26 March 2017

Academic Editor: Takeshi Usui

Copyright © 2017 Yuka Muraoka et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Cryptococcosis usually occurs in immunocompromised patients and can cause enlargement of the adrenal glands, although the morphologic changes after treatment have not been reported in detail. We report the case of 24-year-old man with fevers, headaches, and impaired consciousness who had been treated with glucocorticoids for a protein-losing gastroenteropathy. The cerebrospinal fluid analysis revealed cryptococcal meningitis. Computed tomography showed bilateral adrenal enlargement. A retrospective analysis revealed that the enlargement had been detected 5 months before admission and gradually increased. The enlargement was improved with antifungal therapy and normalized 6 months later. This is the first report describing morphological changes in the adrenal glands associated with cryptococcal meningitis. Adrenal enlargement by cryptococcosis can be improved without any abnormal findings, including calcifications, which may be a unique characteristic from other diseases, including tuberculosis.