Adrenal Hemorrhage in the Adult

Xarli, V P; Steele, AM; Davis, P J; Buescher, E. Stephen; Rios, Carlos N.; Garcia-Bunuel, Rafael

doi:10.1097/00005792-197805000-00002

Cited by 202 publications

(87 citation statements)

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“…Blastic infiltration might be involved in the pathogenesis, since all patients with this situation had high WBC values [15]. On the other hand, these patients had low platelet counts with haemorrhagic diathesis (except patient 8), which might have a contributory effect through adrenal haemorrhage [16]. In patients 1, 5, 6 and 8, fungal infection was detected.…”

Section: Discussionmentioning

confidence: 94%

Hyperkalaemia in acute leukaemia: a sign of adrenocortical insufficiency

Demiroǧlu

Dündar

1997

Journal of Internal Medicine

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Objectives. To evaluate adrenal cortical reserve function in hyperkalaemic patients with acute leukaemia (AL). Design. In hyperkalaemic AL patients, after basal blood collection for cortisol, rapid adrenocorticotropic hormone (ACTH) stimulation test was performed with human a 1-24 -ACTH 0.25 mg, intravenously. Sixty minutes following injection, additional plasma was obtained for cortisol. Normal response was a peak cortisol level greater than 15 g dL Ϫ1 with an increment greater than 5 g dL Ϫ1 . Setting. Hacettepe University Hospital, Ankara, Turkey. Subjects. Newly diagnosed AL patients with plasma K ϩ values exceeding 4.5 mmol L Ϫ1 , who had never received antileukaemia therapy were eligible for entry into the trial. Thirteen patients fulfilled these criteria. Twenty AL patients with normal serum K ϩ levels were studied as controls. Results. In six patients with hyperkalaemia, adrenal cortical response to rapid ACTH test was inadequate. One patient died during induction chemotherapy due to sepsis. Five of the remaining patients entered remission. Repeat ACTH tests during remission revealed normalization of the adrenocortical function in these patients. However, in only one patient with normal serum K ϩ level, adrenocortical reserve was decreased. Conclusions. We suggest that in any AL patient with hyperkalaemia, adrenal reserve function should be evaluated with rapid ACTH stimulation test. In states of resistant hypotension and hyperkalaemia, steroids may be life saving.

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Section: Discussionmentioning

confidence: 94%

Hyperkalaemia in acute leukaemia: a sign of adrenocortical insufficiency

Demiroǧlu

Dündar

1997

Journal of Internal Medicine

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“…Manifesta-se, ainda, com dor abdominal difusa ou localizada nos flancos, relatada em 77% dos pacientes 15 . Náuseas e vômitos ocorrem em 46%; soma-se leucocitose com eosinofilia.…”

Section: Discussionunclassified

“…Hiponatremia, hipoalbuminemia e hiperglicemia são também citadas. Hipoglicemia surge raramente em hemorragias adrenais bilaterais sintomáticas e se presente pode ser secundária a sepse por Gram negativos 15 . A bioquímica pode mostrar um elevado hiato aniônico por acidose metabólica 14 .…”

Section: Discussionunclassified

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Choque séptico puerperal por Streptococcus β-hemolítico e síndrome de Waterhouse-Friderichsen

Araújo

Lana

Garcia

et al. 2009

Rev. Soc. Bras. Med. Trop.

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A infecção puerperal, geralmente causada por bactérias da microbiota vaginal, representa causa comum de morte materna 12 . Entre os fatores de risco, estão más condições de assepsia, parto prolongado, presença de restos ovulares, baixa resposta imunitária e cirurgia cesariana.Cerca de 10% a 30% das mulheres apresentam colonização por estreptococos no trato genital inferior ou reto. Na maioria das gestantes, ocorre infecção assintomática e apenas 2% a 4% evoluem para infecção do trato urinário inferior. O estreptococo do Grupo B pode determinar infecção neonatal, constituindo a principal causa de morbi-mortalidade perinatal. Atualmente, realiza-se a partir da trigésima sexta semana de gestação, cultura genital e perianal para estreptococos. O objetivo é prevenir pela profilaxia com antibióticos, a infecção neonatal. O Streptococcus β-hemolíticos do grupo A (SβHGA) é capaz de causar afecções clínicas, incluindo a própria infecção puerperal, faringite, febre reumática, piodermite, fasciite necrotizante e síndrome do choque tóxico 13 .

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“…Adrenal hemorrhage is associated with infection, postoperative state, thromboembolic disease, anticoagulant therapy, cardiac disease, tumor metastasis, burn, or trauma, and infection is the most commoncomplication (1,2). Fulminant meningococcemia with adrenal hemorrhage is knownas Waterhouse-Friderichsen syndrome(3), while other bacteria, such as Haemophilus influenzae, have been reported to cause adrenal hemorrhage (4,5).…”

Section: Introductionmentioning

confidence: 99%

Adrenal Hemorrhage Associated with Klebsiella Oxytoca Bacteremia.

et al. 1998

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Septic adrenal hemorrhage is classically caused by meningococcemia. An autopsied case is presented of a 45-year-old man with adrenal hemorrhage due to Klebsiella oxytoca bacteremia following placement of a central venous catheter. He died 5 hours after developing disseminated intravascular coagulation (DIC). The bacterial entry site may have been the catheter. The cause of death was considered to be pulmonary edema due to bacteremia rather than adrenal insufficiency due to hemorrhage.Septic adrenal hemorrhageshould be recognized as a subtype of sepsis rather than adrenal insufficiency, and maybe caused in conditions of severe sepsis with DIC, independent of the microorganic variety. (Internal Medicine 37: 990-994, 1998)

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Adrenal Hemorrhage in the Adult

Cited by 202 publications

References 0 publications

Hyperkalaemia in acute leukaemia: a sign of adrenocortical insufficiency

Hyperkalaemia in acute leukaemia: a sign of adrenocortical insufficiency

Choque séptico puerperal por Streptococcus β-hemolítico e síndrome de Waterhouse-Friderichsen

Adrenal Hemorrhage Associated with Klebsiella Oxytoca Bacteremia.

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