Unilateral adrenal hemorrhage after chronic nonsteroidal anti-inflammatory drug use

Nonsteroidal anti-inflammatory drugs, useful in the treatment of a wide variety of major arthritic conditions, have hemorrhagic side effects. We describe a patient receiving long-term naproxen (Naprosyn) therapy in whom unilateral spontaneous adrenal hemorrhage developed. Radiologic and pathologic verifications are included, and a hypothesis of pathogenesis is proposed.