Medical Management of Heparin-Induced Thrombocytopenia Causing Acute Adrenal Insufficiency

Heparin-induced thrombocytopenia is an immune-mediated reaction to heparin and heparin analogs, which results in an acquired hypercoagulability syndrome resulting in paradoxical arterial and venous thrombosis leading to thrombocytopenia. Organs with high vascularity, such as the adrenal glands, are at an increased risk of injury in heparin-induced thrombocytopenia due to thrombus formation in the adrenal vein causing adrenal insufficiency. The standard of treatment remains discontinuation of heparin and heparin analogs and starting corticosteroids and non-heparin antithrombotic therapy such as argatroban.