ADRENAL INSUFFICIENCY IN A PATIENT WITH SEVERE HYPOTENSION CAUSED BY BILATERAL ADRENAL HEMORRHAGE

2002 ◽  
Vol 8 (4) ◽  
pp. 307-310 ◽  
Author(s):  
Evelyn R. Runer ◽  
Juraj Osterman ◽  
J. Robert Brennan
Keyword(s):  
Adrenal Insufficiency ◽  
Adrenal Hemorrhage ◽  
Severe Hypotension ◽  
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.

scholarly journals Adrenal Insufficiency From Bilateral Adrenal Hemorrhage

1990 ◽  
Vol 65 (5) ◽  
pp. 664-670 ◽  
Author(s):  
SAMUEL C.B. SIU ◽  
DALANE W. KITZMAN ◽  
PATRICK F. SHEEDY ◽  
ROBERT C. NORTHCUTT
Keyword(s):  
Adrenal Insufficiency ◽  
Adrenal Hemorrhage ◽  
Bilateral Adrenal Hemorrhage

scholarly journals Spontaneous bilateral adrenal hemorrhage of pregnancy

2017 ◽  
Vol 6 (2) ◽  
pp. 772 ◽  
Author(s):  
Kavya Jonnalagadda ◽  
Nisha Bhavani ◽  
Praveen V. Pavithran ◽  
Harish Kumar ◽  
Usha V. Menon ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Fetal Monitoring ◽  
Serum Cortisol ◽  
Adrenal Hemorrhage ◽  
Normal Vaginal Delivery ◽  
Adrenal Crisis ◽  
Acute Hemorrhage ◽  
Bilateral Adrenal Hemorrhage ◽  
In Pregnancy

Spontaneous adrenal hemorrhage of pregnancy is an acute hemorrhage into the adrenal gland in pregnancy in the absence of trauma, tumor or decoagulant therapy. This can have catastrophic consequences on the mother and the baby and if the hemorrhage involves both the adrenal glands the risk is aggravated because of the high incidence of resulting adrenal insufficiency. We report a case of spontaneous bilateral adrenal hemorrhage in pregnancy resulting in adrenal crisis. A 26 year old primigravida presented at 32 weeks of gestation initially with right sided infrascapular pain and one month later with similar pain in the left side associated with high blood pressure. Imaging with ultrasound and MRI was suggestive of bilateral adrenal mass probably hemorrhage; 2 days following the second episode of pain she developed drowsiness and hypotension and a diagnosis of primary adrenal insufficiency was confirmed by a low serum cortisol and high ACTH. She stabilized with hydrocortisone therapy and the fetus was closely monitored. At 37 weeks she had a normal vaginal delivery under steroid cover. Repeat MRI abdomen 3 months after delivery showed resolution of the hemorrhage but biochemically she continued to be cortisol insufficient at 1 year of follow up. Prompt diagnosis of adrenal hemorrhage in pregnancy and treatment of adrenal insufficiency along with close fetal monitoring usually results in good perinatal outcome in spontaneous adrenal hemorrhage of pregnancy.

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

Rapid Recovery from Adrenal Insufficiency due to Bilateral Adrenal Hemorrhage

1995 ◽  
Vol 5 (4) ◽  
pp. 312-315
Author(s):  
Bart L. Clarke ◽  
H. Stephen Beyer ◽  
Irwin Weisman ◽  
Burt Sharp ◽  
Todd B. Nippoldt
Keyword(s):  
Adrenal Insufficiency ◽  
Adrenal Hemorrhage ◽  
Rapid Recovery ◽  
Bilateral Adrenal Hemorrhage
Sign in / Sign up

Export Citation Format

Share Document