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Adrenal disorders in human immunodeficiency virus (HIV) infected patients.
[adrenal incidentaloma]
Human
Immunodeficiency
Virus
(
HIV
)
infection
is
associated
with
adrenal
disorders
,
which
must
not
be
underestimated
.
Adrenal
morphologic
changes
are
primarily
related
to
opportunistic
infections
,
mostly
by
cytomegalovirus
and
mycobacteria
,
and
malignant
tumours
such
as
non-
Hodgkin
's
lymphoma
and
Kaposi
's
sarcoma
.
The
most
frequent
biological
alteration
reported
to
date
is
the
increases
in
cortisol
concentrations
which
results
from
a
decrease
in
cortisol
metabolism
and
hyperactivity
of
the
hypothalamo-
pituitary
-
adrenal
axis
commonly
referred
to
as
pseudo-
Cushing
's
syndrome
.
These
modifications
can
be
a
consequence
of
antiretroviral
therapy
and
do
not
require
any
investigation
or
specific
treatment
.
Conversely
,
adrenal
insufficiency
,
either
iatrogenic
or
secondary
to
glandular
infiltration
by
neoplasms
or
infections
,
needs
long
-term
substitution
with
hydrocortisone
,
but
at
present
occurs
more
rarely
and
usually
at
late
stages
of
disease
progression
.
The
impact
of
HIV
infection
on
the
other
adrenocortical
functions
has
been
less
reported
in
the
literature
although
several
studies
show
low
levels
of
adrenal
androgens
,
especially
dehydroepiandrostenedione
(
DHEA
)
.
Impairment
in
mineralocorticoid
function
appears
occasional
and
remains
a
subject
of
debate
.
Diseases
Validation
Diseases presenting
"immunodeficiency"
symptom
adrenal incidentaloma
allergic bronchopulmonary aspergillosis
cushing syndrome
dracunculiasis
hirschsprung disease
hodgkin lymphoma, classical
homocystinuria without methylmalonic aciduria
kabuki syndrome
legionellosis
malignant atrophic papulosis
oculocutaneous albinism
omenn syndrome
papillon-lefèvre syndrome
primary effusion lymphoma
primary hyperoxaluria type 1
pyomyositis
severe combined immunodeficiency
sneddon syndrome
werner syndrome
wiskott-aldrich syndrome
wolf-hirschhorn syndrome
x-linked adrenoleukodystrophy
This symptom has already been validated