<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2312-3893</journal-id>
<journal-title><![CDATA[Revista Virtual de la Sociedad Paraguaya de Medicina Interna]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. virtual Soc. Parag. Med. Int.]]></abbrev-journal-title>
<issn>2312-3893</issn>
<publisher>
<publisher-name><![CDATA[Sociedad Paraguaya de Medicina Interna]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2312-38932025000100410</article-id>
<article-id pub-id-type="doi">10.18004/rvspmi/2312-3893/2025.e12142510</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Insuficiencia suprarrenal primaria asociada a micosis sistémica]]></article-title>
<article-title xml:lang="en"><![CDATA[Primary adrenal insufficiency associated with systemic mycosis]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ruiz Cano]]></surname>
<given-names><![CDATA[Viviana Raquel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Insaurralde Franco]]></surname>
<given-names><![CDATA[Eliana Belén]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vega Gill]]></surname>
<given-names><![CDATA[Eduardo Enrique]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Méndez Fernández]]></surname>
<given-names><![CDATA[Cecilia Rosmary]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[González Ramírez]]></surname>
<given-names><![CDATA[Edison Domingo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ramos Galeano]]></surname>
<given-names><![CDATA[Fanny Giselle]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Llanes de Luraschi]]></surname>
<given-names><![CDATA[Gloria Raquel]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Lajarthe Ferreira]]></surname>
<given-names><![CDATA[Ana María]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Universidad Nacional de Asunción Facultad de Ciencias Médicas Hospital de Clínicas]]></institution>
<addr-line><![CDATA[San Lorenzo ]]></addr-line>
<country>Paraguay</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>00</month>
<year>2025</year>
</pub-date>
<volume>12</volume>
<numero>1</numero>
<fpage>410</fpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_arttext&amp;pid=S2312-38932025000100410&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_abstract&amp;pid=S2312-38932025000100410&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://scielo.iics.una.py/scielo.php?script=sci_pdf&amp;pid=S2312-38932025000100410&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[RESUMEN La insuficiencia suprarrenal primaria o enfermedad de Addison es un trastorno poco común y generalmente progresivo, producido por la hipoperfusión de la corteza. Anteriormente se ha considerado a la tuberculosis como la principal causa infecciosa de esta entidad. Sin embargo, en la actualidad, la autoinmune representa la principal etiología. Se describe el caso de un paciente de sexo masculino, de 50 años, portador de hipertensión arterial y antecedente de tuberculosis pulmonar, ganglionar y meníngea, que culminó su tratamiento anti bacilar hace 7 años. Acude por cuadro de 2 meses de evolución de vómitos con progresión a la intolerancia a la vía oral, acompañado de pérdida de peso más astenia. La tomografía computada mostró agrandamiento irregular de ambas suprarrenales. Se realizó una biopsia guiada por tomografía y el estudio histopatológico informó Histoplasma.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[ABSTRACT Primary adrenal insufficiency, or Addison's disease, is a rare and usually progressive disorder caused by hypoperfusion of the cortex. In the past, tuberculosis was considered the main infectious cause of this entity. However, at present, autoimmunity represents the main etiology. We describe the case of a 50-year-old male patient with arterial hypertension and a history of pulmonary, lymph node, and meningeal tuberculosis, who completed his anti-bacillary treatment 7 years ago. He presented with 2 months of vomiting with progression to oral intolerance, accompanied by weight loss and asthenia. Computed tomography showed irregular enlargement of both adrenals. A CT-guided biopsy was performed, and a histopathological study reported Histoplasma.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[insuficiencia suprarrenal]]></kwd>
<kwd lng="es"><![CDATA[tuberculosis extrapulmonar]]></kwd>
<kwd lng="es"><![CDATA[histoplasmosis]]></kwd>
<kwd lng="en"><![CDATA[adrenal insufficiency]]></kwd>
<kwd lng="en"><![CDATA[extrapulmonary tuberculosis]]></kwd>
<kwd lng="en"><![CDATA[histoplasmosis.]]></kwd>
</kwd-group>
</article-meta>
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