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Adrenal insufficiency from bilateral adrenal hemorrhage
S C Siu1, D W Kitzman, P F Sheedy
1Department of Internal Medicine, Mayo Clinic, Rochester, MN 55905.
Mayo Clinic Proceedings
|May 1, 1990
Summary
Bilateral adrenal hemorrhage, a rare cause of adrenal insufficiency, can be diagnosed using abdominal CT scans. Prompt steroid replacement is crucial once suspected in high-risk patients.
Area of Science:
- Endocrinology
- Radiology
- Internal Medicine
Background:
- Bilateral adrenal hemorrhage is an uncommon cause of adrenal insufficiency in adults.
- Nonspecific symptoms of adrenal insufficiency make antemortem diagnosis challenging.
Observation:
- Computed tomographic (CT) scans of the abdomen are valuable for diagnosing bilateral adrenal hemorrhage.
- CT findings include round or oval adrenal masses with high density, decreasing in size and density over time.
- Diagnosis should be considered in complex illnesses, postoperatively, or with coagulopathy, hypotension, fever, or electrolyte disturbances.
Findings:
- The study describes five patients with suspected or confirmed bilateral adrenal hemorrhage via CT scans.
- A circulating lupus anticoagulant was identified in three of the five patients.
- Early steroid replacement therapy is recommended upon suspicion of adrenal hemorrhage.
Implications:
- This highlights the utility of CT imaging in diagnosing bilateral adrenal hemorrhage.
- Identifying associated conditions like lupus anticoagulant is important for patient management.
- Timely diagnosis and steroid replacement are critical for managing adrenal insufficiency due to hemorrhage.