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Spontaneous intracerebral hemorrhage revealing Addison's disease
1Service d'Urgences Cérébrovasculaires, Hôpital Neurologique, Lyon, France.
Cerebrovascular Diseases (Basel, Switzerland)
|July 31, 1998
Summary
Addison's disease, a form of primary adrenocortical insufficiency, can cause spontaneous intracerebral hemorrhage due to clotting issues. Treatment with hydrocortisone resolved these bleeding abnormalities.
Area of Science:
- Endocrinology
- Neurology
- Hematology
Background:
- Addison's disease (primary adrenocortical insufficiency) is an autoimmune condition affecting the adrenal glands.
- Intracerebral hemorrhage is typically associated with hypertension, but nonhypertensive causes are being investigated.
- Coagulation factor deficiencies can lead to bleeding diathesis.
Observation:
- A young woman presented with spontaneous intracerebral hemorrhage.
- She was diagnosed with Addison's disease and premature ovarian failure.
- Initial tests revealed hypofibrinogenemia and prolonged prothrombin time, indicating a vitamin K-dependent coagulation factor deficit.
Findings:
- The patient's coagulation abnormalities resolved within 4 months of hydrocortisone treatment.
- Glucocorticoids, like hydrocortisone, are known to regulate fibrinogen biosynthesis.
- This case suggests a link between primary adrenocortical insufficiency and hemorrhagic diathesis.
Implications:
- Primary adrenocortical insufficiency is a rare but potential cause of nonhypertensive intracerebral hemorrhage.
- This finding expands the known clinical manifestations of Addison's disease.
- Consider screening for Addison's disease in patients with unexplained intracerebral hemorrhage.