A Case of Bilateral Adrenal Hemorrhage: The Exceptional Cause of Adrenal Insufficiency.

acth bilateral adrenal haemorrhage hydrocortisone primary adrenal insufficiency serum cortisol

Journal

Cureus
ISSN: 2168-8184
Titre abrégé: Cureus
Pays: United States
ID NLM: 101596737

Informations de publication

Date de publication:
Mar 2022
Historique:
accepted: 23 03 2022
entrez: 28 4 2022
pubmed: 29 4 2022
medline: 29 4 2022
Statut: epublish

Résumé

Bilateral adrenal hemorrhage is an extremely uncommon and life-threatening condition. It is caused by multiple etiologies, including antiphospholipid syndrome, disseminated histoplasmosis, trauma, severe stress, and granulomatous disease. The authors present a unique case of a 64-year-old alcoholic male, who was admitted after fall and right hip fracture. On day seven of admission, the patient started to develop hypotension, leukocytosis, and tachycardia. CT abdomen was done, which ruled out infectious causes, however, it showed bilateral adrenal hemorrhages. Patient adrenocorticotrophic hormone (ACTH) stimulation test was positive for adrenal insufficiency and was started on hydrocortisone replacement. Our case highlights the fact that adrenal insufficiency after bilateral adrenal hemorrhage can be slow and can manifest as late as seven days and prompt therapy with steroids is warranted to avoid life-threatening adrenal insufficiency.

Identifiants

pubmed: 35481328
doi: 10.7759/cureus.23413
pmc: PMC9033516
doi:

Types de publication

Case Reports

Langues

eng

Pagination

e23413

Informations de copyright

Copyright © 2022, Khakwani et al.

Déclaration de conflit d'intérêts

The authors have declared that no competing interests exist.

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Auteurs

Aemen S Khakwani (AS)

Internal Medicine, Suburban Community Hospital, Norristown, USA.

Fatima Waqar (F)

Internal Medicine, Jefferson Abington Hospital, Abington, USA.

Usman A Khan (UA)

Internal Medicine/Nephrology, University of Oklahoma Health Sciences Center, Oklahoma City, USA.

Muhammad Nadeem Anwar (MN)

Internal Medicine, Oklahoma City Veterans Affairs (VA) Medical Center, Oklahoma City, USA.

Classifications MeSH