abstract: We present the case of a 37 year-old female who had disseminated tuberculosis (TB) with bilateral adrenal
involvement resulting in primary adrenal failure (Addison's disease) with refractory hyponatraemia and possible
extrapontine 'myelinolysis'. Laboratory results were remarkable for adrenal insufficiency. A Mantoux reaction was
positive with evidence of pulmonary miliary TB. The magnetic resonance imaging scan showed all the characteristic
changes of adrenal TB.