Acute adrenal insufficiency in a neonate with bilateral adrenal hemorrhage and combined prothrombotic risk factors

2012 ◽  
Vol 35 (4) ◽  
pp. 449-449 ◽  
Author(s):  
N. Improda ◽  
D. Capalbo ◽  
R. Di Mase ◽  
L. De Martino ◽  
A. Coppola ◽  
...  
Keyword(s):  
Risk Factors ◽  
Adrenal Insufficiency ◽  
Adrenal Hemorrhage ◽  
Acute Adrenal Insufficiency ◽  
Prothrombotic Risk Factors ◽  
Bilateral Adrenal Hemorrhage

scholarly journals Acute adrenal insufficiency due to bilateral adrenal hemorrhage

2011 ◽  
Vol 94 (1) ◽  
pp. 19
Author(s):  
X Zhu ◽  
I C Van der Schaaf ◽  
J A Van der Valk ◽  
A K Bartelink ◽  
M Nix
Keyword(s):  
Adrenal Insufficiency ◽  
Adrenal Hemorrhage ◽  
Acute Adrenal Insufficiency ◽  
Bilateral Adrenal Hemorrhage

scholarly journals Acute Adrenal Insufficiency due to Bilateral Adrenal Hemorrhage.

2011 ◽  
Vol 100 (2) ◽  
pp. 480-482
Author(s):  
Tsubasa Onishi ◽  
Takamichi Kanbayashi ◽  
Isamu Yokoe ◽  
Shinji Tsuruta ◽  
Hitomi Haraoka
Keyword(s):  
Adrenal Insufficiency ◽  
Adrenal Hemorrhage ◽  
Acute Adrenal Insufficiency ◽  
Bilateral Adrenal Hemorrhage

scholarly journals Bilateral Adrenal Hemorrhage in Coronavirus Disease 2019 Patient: A Case Report

2020 ◽  
Vol 105 (12) ◽  
pp. 3745-3749 ◽  
Author(s):  
Meir Frankel ◽  
Itamar Feldman ◽  
Michal Levine ◽  
Yigal Frank ◽  
Naama R Bogot ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Rare Condition ◽  
Renal Vein Thrombosis ◽  
Adrenal Hemorrhage ◽  
Polymerase Chain Reaction Test ◽  
Primary Antiphospholipid Syndrome ◽  
Thromboembolic Events ◽  
Adrenal Axis ◽  
Bilateral Adrenal Hemorrhage ◽  
Life Threatening

Abstract Context Bilateral adrenal hemorrhage is a rare condition with potentially life-threatening consequences such as acute adrenal insufficiency. Early adrenal axis testing, as well as directed imaging, is crucial for immediate diagnosis and treatment. Coronavirus disease 2019 (COVID-19) has been associated with coagulopathy and thromboembolic events. Case description A 66-year-old woman presented with acute COVID-19 infection and primary adrenal insufficiency due to bilateral adrenal hemorrhage (BAH). She also had a renal vein thrombosis. Her past medical history revealed primary antiphospholipid syndrome (APLS). Four weeks after discharge she had no signs of COVID-19 infection and her polymerase chain reaction test for COVID-19 was negative, but she still needed glucocorticoid and mineralocorticoid replacement therapy. The combination of APLS and COVID-19 was probably responsible of the adrenal event as a “two-hit” mechanism. Conclusions COVID-19 infection is associated with coagulopathy and thromboembolic events, including BAH. Adrenal insufficiency is life threatening; therefore, we suggest that early adrenal axis testing for COVID-19 patients with clinical suspicion of adrenal insufficiency should be carried out.

scholarly journals BILATERAL ADRENAL HEMORRHAGE WITH ADRENAL INSUFFICIENCY AFTER DALTEPARIN USE POST HIP ATHROPLASTIES

2020 ◽  
Vol 6 (3) ◽  
pp. e141-e143 ◽  
Author(s):  
Robyn L. Houlden ◽  
Azraa Janmohamed
Keyword(s):  
Platelet Count ◽  
Adrenal Insufficiency ◽  
Epigastric Pain ◽  
Laboratory Data ◽  
Adrenal Hemorrhage ◽  
Nausea And Vomiting ◽  
Dvt Prophylaxis ◽  
Post Surgery ◽  
Bilateral Adrenal Hemorrhage ◽  
Hip Arthroplasties

Objective: Multiple case reports have implicated the use of heparin for deep vein thrombosis (DVT) prophylaxis with bilateral adrenal hemorrhage. Only 1 previous report has described this with the low molecular weight product, dalteparin. We report a case following bilateral hip arthroplasties. Methods: Clinical and laboratory data are presented. Results: A 69-year-old woman underwent bilateral total hip arthroplasties with dalteparin 5,000 international units subcutaneously daily for 30 days postoperatively. The patient's past medical history was unremarkable. She was discharged 5 days post-surgery and required readmission 1 day later for epigastric pain, nausea, and vomiting. Her platelet count was 91 × 109/L (normal, 150 to 400 × 109/L). She was discharged after 4 days with pain resolution. She presented 4 weeks later with nausea and vomiting for several days. Serum sodium was 123 mmol/L (normal, 133 to 145 mmol/L), potassium was 6.0 mmol/L (normal, 3.7 to 5.3 mmol/L), total calcium was 3.37 mmol/L (normal, 2.25 to 2.80 mmol/L), creatinine was 404 μmol/L (normal, 0 to 85 μmol/L), and her platelet count was normal. On short adrenocorticotropic hormone stimulation test, baseline plasma cortisol was 123 nmol/L and the peak was 129 nmol/L. She was treated with hydrocortisone, fludrocortisone, and 0.9% saline with resolution of symptoms and normalization of electrolytes, calcium, and renal function. Computed tomography showed bilateral adrenal masses. Core needle biopsy was consistent with necrosis. There were no bleeding disorders on hematologic work 3 months later. The most likely etiology of bilateral adrenal hemorrhage was heparin-induced thrombocytopenia from dalteparin. Conclusion: This case highlights the importance of vigilance for the complication of bilateral adrenal hemorrhage with adrenal insufficiency in patients receiving dalteparin for DVT prophylaxis.

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