Acute Spontaneous Bilateral Adrenal Hemorrhage Presenting as Hyponatremia

被引:0
作者
Chippa, Venu Madhav [1 ]
Chenna, Swetha [2 ]
Gujarathi, Rahul [3 ]
Candula, Narsimha [4 ]
机构
[1] St Vincents Med Ctr, Internal Med, Evansville, IN 47714 USA
[2] Indiana Univ, Internal Med, Indianapolis, IN USA
[3] Univ Florida Hlth, Hosp Med, Jacksonville, FL USA
[4] Univ Florida, Hosp Med, Coll Med, Jacksonville, FL USA
关键词
confusion; hypotension; hyponatremia; adrenal insufficiency; adrenal hemorrhage; INSUFFICIENCY; EPIDEMIOLOGY; PREVALENCE;
D O I
10.7759/cureus.33060
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Bilateral adrenal hemorrhage is a very unusual cause of severe adrenal insufficiency and hyponatremia. It can result from trauma, infections, or antiphospholipid antibody syndrome and can be fatal if not diagnosed and treated early. Here, we present a 58-year-old Caucasian man with fatigue, altered sensorium, bradycardia, and hypotension. He denied any abdominal pain, recent trauma, or anti-platelet or anti-coagulation agents. His laboratory workup showed hyponatremia with low serum cortisol levels. He was further worked up and underwent computerized tomography (CT) of the abdomen, which showed bilateral adrenal hemorrhage. He was treated with intravenous (IV) steroids followed by oral hydrocortisone and fludrocortisone. His symptoms resolved, and he was safely discharged home. Asymptomatic bilateral adrenal hemorrhage is a sporadic disease, and it should be in the differential diagnosis for disproportionately sick people with other adrenal insufficiency features.
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页数:5
相关论文
共 15 条
[1]   Group 1. Epidemiology of primary and secondary adrenal insufficiency: Prevalence and incidence, acute adrenal insufficiency, long-term morbidity and mortality [J].
Chabre, Olivier ;
Goichot, Bernard ;
Zenaty, Delphine ;
Bertherat, Jerome .
ANNALES D ENDOCRINOLOGIE, 2017, 78 (06) :490-494
[2]   Hyponatremia in the elderly: challenges and solutions [J].
Filippatos, Theodosios D. ;
Makri, Andromachi ;
Elisaf, Moses S. ;
Liamis, George .
CLINICAL INTERVENTIONS IN AGING, 2017, 12 :1957-1965
[3]   ADRENAL INSUFFICIENCY IN A PATIENT WITH ACQUIRED-IMMUNODEFICIENCY-SYNDROME [J].
FUJII, K ;
MORIMOTO, I ;
WAKE, A ;
OKADA, Y ;
INOKUCHI, N ;
ISHIDA, O ;
NAKANO, Y ;
ODA, S ;
ETO, S .
ENDOCRINE JOURNAL, 1994, 41 (01) :13-18
[4]  
GAGNON REAL, 1956, REV CANADIENNE BIOL, V14, P350
[5]   Bilateral massive adrenal hemorrhage - Assessment of putative risk factors by the case-control method [J].
Kovacs, KA ;
Lam, YM ;
Pater, JL .
MEDICINE, 2001, 80 (01) :45-53
[6]   Spontaneous Adrenal Hemorrhage with Associated Masses: Etiology and Management in 6 Cases and a Review of 133 Reported Cases [J].
Marti, Jennifer L. ;
Millet, John ;
Sosa, Julie Ann ;
Roman, Sanziana A. ;
Carling, Tobias ;
Udelsman, Robert .
WORLD JOURNAL OF SURGERY, 2012, 36 (01) :75-82
[7]   Bilateral adrenal hemorrhage after colectomy for perforated diverticulitis: A case report [J].
Monzavi, C. A. Esparza ;
Hamed, A. ;
Nordenstam, J. ;
Gantt, G., Jr. .
INTERNATIONAL JOURNAL OF SURGERY CASE REPORTS, 2021, 78 :336-339
[8]   ADRENAL HEMORRHAGE - A COMPLICATION OF ANTICOAGULANT-THERAPY - A CASE-HISTORY [J].
OGNIBENE, AJ ;
MCBRIDE, H .
ANGIOLOGY, 1987, 38 (06) :479-483
[9]   INCREASING PREVALENCE OF ADDISON DISEASE: RESULTS FROM A NATIONWIDE STUDY [J].
Olafsson, Andri Snaer ;
Sigurjonsdottir, Helga Agusta .
ENDOCRINE PRACTICE, 2016, 22 (01) :30-35
[10]  
Prabhasavat Krisdee, 2015, Journal of the Medical Association of Thailand, V98, P621