2025 ICD-10-CM code A18.7
(Active) Effective Date: N/A Certain infectious and parasitic diseases - Tuberculosis 1 Feed
Tuberculosis of adrenal glands. Tuberculous Addison's disease.
Medical necessity is established by the diagnosis of adrenal tuberculosis. This diagnosis requires documentation of signs, symptoms, and diagnostic test results confirming the involvement of the adrenal gland with Mycobacterium tuberculosis.
Clinicians should consider adrenal tuberculosis in patients with a history of TB (active or latent) presenting with symptoms of adrenal insufficiency, such as fatigue, weakness, anorexia, nausea, vomiting, skin hyperpigmentation, hypotension, and electrolyte abnormalities. Diagnosis involves blood tests, tuberculin skin test, imaging (CT scans may reveal adrenal enlargement, calcifications, and atrophy), and biopsy for definitive confirmation. Treatment involves antituberculous chemotherapy (isoniazid, rifampin, rifabutin, pyrazinamide, ethambutol) and, if necessary, adjunctive steroid therapy to prevent adrenal crisis.
In simple words: Tuberculosis can affect the adrenal glands, which are located on top of your kidneys. This is rare and happens when TB bacteria spread through the bloodstream to the adrenal glands.If the infection is severe, it can lead to adrenal insufficiency, also known as Addison's disease. This means the adrenal glands can't produce enough essential hormones.
Tuberculosis (TB) of the adrenal glands is a rare manifestation of extrapulmonary tuberculosis. It arises from the reactivation of Mycobacterium tuberculosis or, less commonly, Mycobacterium bovis, initially lodged in the adrenal glands via hematogenous spread.Destruction of the adrenal glands can lead to adrenal insufficiency (Addison's disease).
Example 1: A patient with a history of pulmonary tuberculosis presents with fatigue, weight loss, low blood pressure, and hyperpigmentation.A CT scan reveals bilateral adrenal enlargement and calcification.Biopsy confirms adrenal tuberculosis., A patient with a positive tuberculin skin test develops weakness, nausea, vomiting, and skin darkening. Blood tests reveal hyponatremia and hyperkalemia.A diagnosis of adrenal tuberculosis with adrenal insufficiency is made., A patient undergoing treatment for active pulmonary tuberculosis develops symptoms suggestive of adrenal insufficiency.Further investigation reveals adrenal gland involvement as part of disseminated tuberculosis.
Documentation should include evidence of active or latent tuberculosis, clinical findings of adrenal insufficiency, results of blood tests and tuberculin skin test, imaging findings (e.g., CT scan), and biopsy results confirming the diagnosis of adrenal tuberculosis.
- Specialties:Infectious Disease, Endocrinology
- Place of Service:Inpatient Hospital, Outpatient Hospital, Office