TAFRO Syndrome with Massive Bilateral Adrenal Hemorrhage

We report the case of a 62-year-old man who presented with bilateral adrenal enlargement and systemic lymphadenopathy. Imaging and clinical findings led to the diagnosis of bilateral adrenal hemorrhage. Bone marrow aspiration and lymph node biopsy confirmed TAFRO syndrome, which met the established diagnostic criteria. Although adrenal hemorrhage in TAFRO syndrome is exceedingly rare, this case is unique, as it represents the first reported instance of massive bilateral adrenal hemorrhage with confirmed progression. This case underscores the need for awareness regarding this potential complication of TAFRO syndrome.