Spontaneous Idiopathic Bilateral Adrenal Haemorrhage in Adults

Postoperative bilateral adrenal hemorrhage: correlation between clinical and radiological signs

“…Spontaneous cases also have been reported [16]. In our patient, the cause was probably one of the three isolated microorganisms, although it was not possible to single out any one of them conclusively.…”

“…In our patient, the cause was probably one of the three isolated microorganisms, although it was not possible to single out any one of them conclusively. Among the pathogenic mechanisms suggested in the literature, perhaps the most feasible is the local manifestation of an excessive release of cytokines [9][10][11][12][13][14][15][16][17], particularly of tumor necrosis factor α (TNF-α), interleukin-β (IL β), interferon gamma (INF-γ), and IL-12, in response to stress. This cytokine release would result in an activation of coagulation cascade, inhibition of fibrinolysis, and endothelial damage.…”

Spontaneous idiopathic bilateral adrenal haemorrhage: a rare cause of abdominal pain

“…Non-traumatic causes include anticoagulant use (mostly heparin-induced thrombocytopaenia), thromboembolic disease, antiphospholipid syndrome (APS), severe sepsis/septic shock due to meningococcaemia, Streptococcus pneumoniae and Haemophilus influenza , among others, and malignancy, haematological disorders, pregnancy and adrenal masses, inter alia 3–9. All were essentially ruled out, making this a rare case of spontaneous idiopathic bilateral adrenal haemorrhage 10 11. Although our patient had mild respiratory tract infection symptoms 1 week prior to presentation, they were not significant enough to cause severe stress precipitating adrenal haemorrhage.…”

Bilateral adrenal hemorrhage: An overlooked cause of hypotension

“…Adrenal insufficiency due to bilateral adrenal hemorrhage can be caused by blunt abdominal trauma, antiphospholipid syndrome, thermal injuries, sepsis, anticoagulation (mostly associated with recent heparin use), adrenocorticotrophic hormone (ACTH) treatment, or can be idiopathic (3)(4)(5)(6)(7)(8)(9). Anticoagulation was the most likely cause in the current patient.…”

“…Before testing, dexamethasone can be used as corticosteroid replacement because it is not measured by the cortisol assay. Computed tomography or MRI can exhibit radiological features highly suggestive of adrenal hemorrhage, with rounded enlargement of the adrenal glands, and variable density depending on the age of the hematoma (9). Other causes of bilateral adrenal enlargement leading to adrenal insufficiency include granulomatous infections, amyloidosis, and infiltrative disorders.…”