Mrs M . Of 30 years is moving here and there for five years to get relief in various Bizzare symptoms In 2009 she delivered normally baby and had bleeding (oh)and malarial fever, stich infection and treated! in 2011 had second ND, pph + after this she is suffering from various problems and not getting relief, one week back,she came to me and I noticed her Nuckles are black then fingers. Apart from All investigation I ordered s.cortisol 10 am which turn out to be very low11.78 n mol/ l ( n 171---536).
Ct brain with emphasis on pituitary found normal. On further inquiring about TB in family,her grandma and one uncle had TB ,she stayed with them for three months in each delivery. She is on oral contraceptive like tables from gynaecologist for getting regular menses for two years her X-ray chest shows nodular shadow inboth hila and above areas? Old Koch,s chest.Rest almost all inv.are…
