Bilateral Adrenal Hemorrhage in a Patient with Myelodysplastic Syndrome: Value of MRI in the Differential Diagnosis

Manganaro, Lucia; Ansari, Najwa Al; Barchetti, Flavio; Saldari, Matteo; Vitturini, Claudia; Glorioso, M; Buonocore, Valeria; Barchetti, Giovanni; Maccioni, Francesca

doi:10.1155/2013/479836

Cited by 6 publications

(5 citation statements)

References 22 publications

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“…Based on our observations and other similar cases, Table 1 shows the expected intensity of normal, infarcted, and hemorrhagic glands on typical MR imaging sequences [1,7,8,10,12,14,[17][18][19].…”

Section: Discussionsupporting

confidence: 63%

“…The infarcted adrenal gland measures at 874 units, indicating greater restricted diffusion due to infarcted parenchyma. The findings of edema, swelling, and greater restricted diffusion were considered diagnostic of right adrenal gland infarct [2,8,[9][10][11][12][13][14][15][16][17][18][19]. Our patient's hospital course followed with a complete hypercoagulability panel, hematology/oncology and endocrinology consultations.…”

Section: Case Presentationmentioning

confidence: 92%

Section: Case Presentationmentioning

confidence: 99%

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Diffusion Weighted Imaging in Unilateral Adrenal Infarction: A Case of Colicky Right Upper Quadrant Pain in a Pregnant Female

Padilla¹,

Way²,

Soule³

et al. 2021

Cureus

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Diffusion weighted imaging (DWI) is a magnetic resonance imaging (MRI) non-contrast sequence that can indicate tissue ischemia or infarction. Adrenal infarct may present similarly to biliary or gallbladder pathologies, and the differential diagnosis during emergency work-up can be narrowed utilizing DWI sequences. In this paper, we describe the usefulness of DWI for urgent diagnosis in a case of nonhemorrhagic adrenal infarct of a pregnant female presenting with right upper quadrant pain. Although uncommon, adrenal infarct may occur in patients with hypercoagulability and localizing pain that is unexplained by other imaging modalities. We outline the imaging features of DWI in evaluating adrenal infarct as a safe and time effective application for patients with contraindications to imaging with ionizing radiation.

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Section: Discussionsupporting

confidence: 63%

Section: Case Presentationmentioning

confidence: 92%

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Diffusion Weighted Imaging in Unilateral Adrenal Infarction: A Case of Colicky Right Upper Quadrant Pain in a Pregnant Female

Padilla¹,

Way²,

Soule³

et al. 2021

Cureus

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“…The resolution time of 12.6 w (range: [8][9][10][11][12][13][14][15][16][17][18][19][20] is comparable to what have been reported [16,18,23]. Furthermore, with the modern imaging particularly computed tomography (CT)-and magnetic resonance imaging (MRI) the diagnosis of AH is frequently made easily [35][36][37]. Positron emission tomography (PET) scan could be of value in diagnosis [38].…”

Section: Discussionmentioning

confidence: 61%

Adrenal haemorrhage in the new born: revisited

Al-Jurayyan¹,

Al-Hakami²,

Al-Jurayyan³

2018

biomedicalresearch

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Background: Adrenal haemorrhage (AH) in the new-born is not that uncommon and has been reported frequently. AH occurs most often after a traumatic delivery or complicated neonatal course. Design and setting: A retrospective, hospital-based study conducted at king Khalid university hospital (KKUH), endocrine service, Riyadh, Saudi Arabia, during the period January 2014 and July 2018. Methods: Medical records of neonates who had been diagnosed to have AH were reviewed. Data included age, sex, clinical manifestations, laboratory and radiological investigations. Results: During the period under review, five neonates were diagnosed to have adrenal haemorrhage. All were term male infants, who were delivered vaginally .one baby was large for gestational age (LGA), and three babies had perinatal hypoxemia. Clinical symptoms were not specific and diagnosis was confirmed by performing abdominal sonography (USG). Conclusion: AH should be recognised in the new-borns with nonspecific symptoms who had potential risk factors. Abdominal ultrasonography (USG) should be performed to diagnose AH, and monitor its progress. Adrenal hormone testing also should be performed.

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“…Adrenal hemorrhage is an uncommon condition of serious concern, as it may result in adrenal insufficiency and death (8). The exact incidence of adrenal hemorrhage in the general population is unknown (8)(9)(10). Bilateral adrenal hemorrhage is especially very rare.…”

Section: Discussionmentioning

confidence: 99%

A Case of Spontaneous Regression of Idiopathic Bilateral Adrenal Hemorrhage in a Middle Aged Woman: 1 Year Follow-up

Song

Park

et al. 2016

Acta Endo (Buc)

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Background. Bilateral adrenal hemorrhage is a serious condition that can result in adrenal insufficiency, shock, acute adrenal crisis, and mortality if it is not managed with adequate treatment. We report a rare case of idiopathic bilateral adrenal hemorrhage.Case presentation. A 50-year-old woman visited our hospital with complaints of right upper abdominal pain. A computed tomography (CT) revealed unilateral left adrenal gland hemorrhage. However, the results of rapid adrenocorticotropic hormone (ACTH) stimulation test and adrenomedullary hormone function test were normal. Since the patient did not show signs of adrenal insufficiency, corticosteroid therapy was postponed and only supportive management therapy was started. After 1 week, a followup CT showed a previously unseen adrenal hemorrhage on the right adrenal gland, but the rapid ACTH stimulation test result was normal. One year later, no hemorrhagic signs were observed on the follow-up CT. Conclusion.In most cases of idiopathic bilateral adrenal hemorrhage, patients are treated with steroid replacement therapy due to adrenal insufficiency. In some other cases, patients are treated with steroids despite the absence of adrenal insufficiency. Here we reported a very rare case of idiopathic bilateral adrenal hemorrhage sequentially to emphasize that before initiation of adrenal hormone replacement therapy, it is important to determine whether adrenal insufficiency is present. If there is no evidence of adrenal insufficiency, adrenal replacement therapy should be postponed until the presence of adrenal insufficiency is confirmed.

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Bilateral Adrenal Hemorrhage in a Patient with Myelodysplastic Syndrome: Value of MRI in the Differential Diagnosis

Cited by 6 publications

References 22 publications

Diffusion Weighted Imaging in Unilateral Adrenal Infarction: A Case of Colicky Right Upper Quadrant Pain in a Pregnant Female

Diffusion Weighted Imaging in Unilateral Adrenal Infarction: A Case of Colicky Right Upper Quadrant Pain in a Pregnant Female

Adrenal haemorrhage in the new born: revisited

A Case of Spontaneous Regression of Idiopathic Bilateral Adrenal Hemorrhage in a Middle Aged Woman: 1 Year Follow-up

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