Acute adrenal insufficiency due to adrenal hemorrhage complicating colorectal surgery: Report of two cases and correlation with the antiphospholipid antibody syndrome

Kolinioti, Angeliki; Tsimaras, Michalis; Stravodimos, Georgios; Komporozos, Vasileios

doi:10.1016/j.ijscr.2018.07.034

Cited by 14 publications

(13 citation statements)

References 18 publications

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“…Despite treatment with fludrocortisone in 13/16 patients in the 16-patient case series, aldosterone levels were only assessed in 6 patients. Similarly, in 4 case reports that describe 5 cases of BAI/H, aldosterone levels were measured in 1 case (7,12,13,16). Fludrocortisone therapy was prescribed in this case and in one other; all 5 patients were treated with a glucocorticoid.…”

Section: Discussionmentioning

confidence: 96%

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Evolving Adrenal Dysfunction After Bilateral Adrenal Infarction: A Case Report

You

Fleischer

Abraham

2019

AACE Clinical Case Reports

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Objective: To describe a case of sequential bilateral adrenal infarction and hemorrhage resulting in an unusual pattern of adrenal function over time. Methods: A 50-year-old male with autoimmune antiphospholipid syndrome (APS) presented to the emergency room with severe abdominal pain. Diagnostic studies performed included contrast-enhanced computerized tomographic (IV-CT) imaging of abdomen and pelvis, and laboratory assessment of the hypothalamic-pituitary-adrenal axis. Results: IV-CT of abdomen and pelvis on day 1 showed acute left adrenal gland infarction; cortisol level was 19.9 μg/dL and serum sodium was 133 mEq/L. The patient subsequently developed hyponatremia and hypotension. Repeat IV-CT of abdomen and pelvis on day 3 showed hemorrhagic conversion of the left infarcted adrenal gland and a new right adrenal gland infarction. Cosyntropin stimulation test (CST) confirmed primary glucocorticoid insufficiency. Plasma renin activity and the serum aldosterone level were within normal limits with normokalemia. At 7-month follow-up, CST demonstrated cortisol and aldosterone deficiency. Conclusion: Adrenal infarction is a rare complication of APS but is the most common endocrine complication. Evidence of bilateral adrenal infarction on imaging does not predict the type of adrenal dysfunction that might ensue, as demonstrated in this case. Thorough evaluation of glucocorticoid, mineralocorticoid, and androgen deficiency should be conducted both at the time of the event and in follow-up.

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Section: Discussionmentioning

confidence: 96%

“…tion, there are reports of patients that have recovered both glucocorticoid and mineralocorticoid function over time (2 years) (8,16).…”

mentioning

confidence: 99%

Evolving Adrenal Dysfunction After Bilateral Adrenal Infarction: A Case Report

You

Fleischer

Abraham

2019

AACE Clinical Case Reports

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“…BAH is a rare but potentially catastrophic complication. The reported inducing factors include trauma, surgery, anticoagulants, infection, myocardial infarction, chronic heart failure, APS, and HIT [4–8]. Cases without any of above risk factors have also been reported in previous literature [2, 3].…”

Section: Discussionmentioning

confidence: 99%

“…Mandanas S [9] had reviewed 36 such cases in the year of 2013. Herein, we made a further literature search and 12 additional cases published after the year of 2013 were summarized in Table 1 [6, 8–16]. The mechanism of AH has not been fully elucidated.…”

Section: Discussionmentioning

confidence: 99%

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Bilateral adrenal hemorrhage after hip arthroplasty: an initially misdiagnosed case

Wang

Qin

et al. 2019

BMC Urol

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BackgroundBilateral adrenal hemorrhage (BAH) is a rare but potentially catastrophic condition. Its clinical manifestation is often non-specific and sometimes difficult to be diagnosed in time.Case summaryA 57-year-old woman, who presented with severe fatigue, nausea and vomiting after left hip arthroplasty due to her femoral neck fracture in a local hospital, was transferred to our medical center. Laboratory results revealed significant hyponatremia, low serum cortisol and elevated serum ACTH. Computed tomography (CT) showed a bilateral adrenal mass, measured 3.6 × 2.7 cm on the left and 3.4 × 2.3 cm on the right. Further magnetic resonance imaging (MRI) confirmed the diagnosis of BAH. The patient was prescribed with oral prednisolone acetate, 5 mg, tid, and her condition improved gradually. Nine months after, the patient was in good condition with 5 mg prednisolone acetate per day. CT revealed a clearly shrunken adrenal mass compared with 9 months ago.ConclusionsThis case illustrates the difficulty in making the diagnosis of BAH with atypical presentation. Such cases necessitate greater alertness on the part of the clinician and require rapid diagnosis and prompt glucocorticoid replacement for better clinical outcomes.

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Acute abdominal pain due to atypical bilateral adrenal infarction in acute myeloid leukemia with alterations related to myelodysplasia: A case report

Hirata,

Tago,

Yamashita

et al. 2023

Clinical Case Reports

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Key Clinical MessageAcute myeloid leukemia (AML) can cause acute abdomen following adrenal insufficiency or adrenal infarction. Therefore, when diffusely enlarged adrenal glands and adrenal insufficiency of unknown cause are seen in a patient presenting with acute abdomen, adrenal infarction due to AML, or other hematologic diseases should be ruled out.AbstractA 49‐year‐old man developed acute abdominal pain following adrenal insufficiency and was diagnosed with acute myeloid leukemia (AML) with myelodysplasia‐related changes. Because AML can cause acute abdominal pain due to adrenal infarction following adrenal insufficiency, a patient with these conditions should be ruled out adrenal infarction due to AML or other hematologic diseases.

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Acute adrenal insufficiency due to adrenal hemorrhage complicating colorectal surgery: Report of two cases and correlation with the antiphospholipid antibody syndrome

Cited by 14 publications

References 18 publications

Evolving Adrenal Dysfunction After Bilateral Adrenal Infarction: A Case Report

Evolving Adrenal Dysfunction After Bilateral Adrenal Infarction: A Case Report

Bilateral adrenal hemorrhage after hip arthroplasty: an initially misdiagnosed case

Acute abdominal pain due to atypical bilateral adrenal infarction in acute myeloid leukemia with alterations related to myelodysplasia: A case report

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