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Bilateral massive adrenal hemorrhage due to sepsis: Report of two cases

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Abstract

Two cases (a 57-year-old man and an 18-year-old girl) of bilateral massive adrenal hemorrhage (BMAH) due to sepsis (Streptococcus pneumoniae and Neisseira meningitidis, respectively) are reported. At admission, the man presented with fever, severe hypotension, hyperazotemia, acidosis, normonatremia and hypocoagulability, while the girl with severe hypotension, fever, hyponatremia, and hypocoagulability. A diagnostic protocol based on a very quick method for cortisol measurement is proposed, in an attemp to reach an earlier diagnosis of BMAH during sepsis.

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References

  1. Werbet S.S., Ober K.P. Acute adrenal insufficiency. Endocrinol. Metab. Clin. North Am. 22: 103, 1993.

    Google Scholar 

  2. Rao R.H., Vagnucci A.H., Amico J.A. Bilateral massive adrenal hemorrhage: early recognition and treatment. Ann. Intern. Med. 110: 227, 1989.

    Article  CAS  PubMed  Google Scholar 

  3. Bone R.C. Why new definitions of sepsis and organ failure are needed. Medicine 57: 348, 1993.

    Article  Google Scholar 

  4. Xarli V.P., Steele A.A., Davis P.J., Buescher E.S., Rias C.N., Garcia-Brunnel R. Adrenal hemorrhage in adults. Medicine 57: 211,1978.

    Article  CAS  PubMed  Google Scholar 

  5. Dahlberg P.J., Gaeller M.H., Pehlinh G.B. Adrenal insufficiency due to adrenal hemorrhage. Two case reports and a review of cases confirmed by computed tomography. Arch. Item. Med. 150: 905, 1990.

    Article  CAS  Google Scholar 

  6. Fourrier F., Lestavel P., Chopin C., Morey A., Goudemand J., Rime A., Mongalabayi J. Meningococcemia and purpura fulminans in adults: acute deficiency of proteins C and S and early treatment with antithrombin III concentrates. Intensive Care Med. 16: 121, 1990.

    Article  CAS  PubMed  Google Scholar 

  7. Ansell J.E., Price J.M., Shah S., Beenner R.R. Heparin induced thrombocytopenia. What the real frequency? Chest 88: 878, 1985.

    Article  CAS  PubMed  Google Scholar 

  8. Fitzpatric P.M., Swensen S.J. Report of an unusual case of postoperative adrenal hemorrhage in a young woman. Am. J. Med. 86: 487, 1989.

    Article  Google Scholar 

  9. Siu S.C.B., Kitzman D.W., Sheedy P.F. II, Northcatt R.C. Adrenal insufficiency from bilateral adrenal hemorrhage. Mayo Clin. Proc. 65: 664, 1990.

    Article  CAS  PubMed  Google Scholar 

  10. Marcus H.I., Connon J.J., Stern H.S. Bilateral adrenal hemorrhage during ACTH treatment of ulcerative colitis: report of a case and review of the literature. Dis. Colon Rectum 29: 130, 1958.

    Article  Google Scholar 

  11. Galin M.A. Unilateral adrenal hemorrhage during ACTH therapy. N. Engl. J. Med. 258: 954, 1958.

    Article  Google Scholar 

  12. Levin J., Cluff L.E. Endotoxinemia and adrenal hemorrhage: a mechanism for the Waterhouse-Friderichsen syndrome. J. Exp. Med. 121: 247, 1965.

    Article  CAS  PubMed Central  PubMed  Google Scholar 

  13. Chattopadhyay S., Johnson D.D., Millar G.J. Jaques L.B. The effect of stress and Warfarin on the adrenal gland in relation to spontaneous hemorrhage as judged by measurement of ascorbic acid and serum cortisone. Diath. Hoemorrh. 26: 275, 1971.

    CAS  Google Scholar 

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Authors and Affiliations

  1. Servizio di Anestesia e Rianimazione USL 10/D, Universitá di Firenze, Firenze, Italy

    A. Piccioli & G. Chini

  2. Dipartimento di Fisiopatologia Clinica, Unità di Endocrinologia, Universitá di Firenze, Firenze, Italy

    M. Mannelli & M. Serio M.D.

Authors
  1. A. Piccioli
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  2. G. Chini
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  3. M. Mannelli
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  4. M. Serio M.D.
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Piccioli, A., Chini, G., Mannelli, M. et al. Bilateral massive adrenal hemorrhage due to sepsis: Report of two cases. J Endocrinol Invest 17, 821–824 (1994). https://doi.org/10.1007/BF03347786

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  • DOI: https://doi.org/10.1007/BF03347786

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