HEPARIN-ASSOCIATED THROMBOCYTOPENIA SYNDROME - AN UNDERESTIMATED ETIOLOGY OF ADRENAL HEMORRHAGE

被引:19
作者
DELHUMEAU, A
MOREAU, X
CHAPOTTE, C
HOUI, N
BIGORGNE, JC
机构
[1] Department of Anesthesiology, Centre Hospitalier Universitaire d'Angers, Angers Cedex
关键词
HEPARIN THROMBOCYTOPENIA; ADRENAL HEMORRHAGE; ADRENAL REGRESSIVE INSUFFICIENCY;
D O I
10.1007/BF01711091
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
A 74-year-old man developed bilateral arterial thrombosis of the lower limbs related to heparin-associated thrombocytopenia syndrome (HATS). On day 4 after thrombectomy of both limbs, abdominal pain, fever, hypotension, abdominal tenderness appeared. Acute acalculous cholecystitis was suspected and cholecystectomy was carried out although the gallbladder was not imflamed. Later on, hyponatremia in addition to the aforesaid signs suggested the diagnosis of adrenal insufficiency. Diagnosis was confirmed by low cortisol and aldosterone plasma concentration and by CT scan, which showen two enlarged adrenal glands. HATS might explain two unexpected facts: occurence of adrenal hemorrhage during heparin therapy with coagulation tests within the therapeutic range and paradoxical thrombosis in the central vein of adrenal gland. HATS must be regarded as one cause of adrenal hemorrhage necrosis.
引用
收藏
页码:475 / 477
页数:3
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