tetano
Editor, Senior Moderator
J Clin Endocrinol Metab
. 2020 Aug 1;dgaa487.
doi: 10.1210/clinem/dgaa487. Online ahead of print.
Bilateral adrenal hemorrhage in Coronavirus disease 2019 patient: A case report
Meir Frankel[SUP] 1 [/SUP], Itamar Feldman[SUP] 2 [/SUP], Michal Levine[SUP] 3 [/SUP], Yigal Frank[SUP] 4 [/SUP], Naama R Bogot[SUP] 4 5 [/SUP], Ofer Benjaminov[SUP] 4 5 [/SUP], Ramzi Kurd[SUP] 3 [/SUP], Gabriel S Breuer[SUP] 2 3 5 [/SUP], Gabriel Munter[SUP] 1 3 5 [/SUP]
Affiliations
Abstract
Context: Bilateral adrenal hemorrhage is a rare condition with potentially life-threatening consequences as acute adrenal insufficiency. Early adrenal axis testing, as well as directed imaging, is crucial for immediate diagnosis and treatment. Coronavirus disease 2019 (COVID-19) has been associated with coagulopathy and thromboembolic events.
Case decription: A 66-years-old woman presented with acute COVID-19 infection and primary adrenal insufficiency due to bilateral adrenal hemorrhage (BAH). She had also a renal vein thrombosis. Her past medical history revealed primary antiphospholipid syndrome (APLS). 4 weeks after discharge she had no signs of COVID-19 infection and her PCR test for COVID-19 was negative, but she still needed glucocorticoid and mineralocorticoid replacement therapy. The combination of APLS and COVID-19 was probably responsible of the adrenal event as a "two-hit" mechanism.
Conclusions: COVID-19 infection is associated with coagulopathy and thromboembolic events, including BAH. Adrenal insufficiency is life threatening, therefore we suggest to consider performing early adrenal axis testing for COVID-19 patients with clinical suspicion of adrenal insufficiency.
Keywords: Adrenal hemorrhage; Adrenal insufficiency; Antiphospholipid syndrome; COVID-19; Renal vein thrombosis.
. 2020 Aug 1;dgaa487.
doi: 10.1210/clinem/dgaa487. Online ahead of print.
Bilateral adrenal hemorrhage in Coronavirus disease 2019 patient: A case report
Meir Frankel[SUP] 1 [/SUP], Itamar Feldman[SUP] 2 [/SUP], Michal Levine[SUP] 3 [/SUP], Yigal Frank[SUP] 4 [/SUP], Naama R Bogot[SUP] 4 5 [/SUP], Ofer Benjaminov[SUP] 4 5 [/SUP], Ramzi Kurd[SUP] 3 [/SUP], Gabriel S Breuer[SUP] 2 3 5 [/SUP], Gabriel Munter[SUP] 1 3 5 [/SUP]
Affiliations
- PMID: 32738040
- DOI: 10.1210/clinem/dgaa487
Abstract
Context: Bilateral adrenal hemorrhage is a rare condition with potentially life-threatening consequences as acute adrenal insufficiency. Early adrenal axis testing, as well as directed imaging, is crucial for immediate diagnosis and treatment. Coronavirus disease 2019 (COVID-19) has been associated with coagulopathy and thromboembolic events.
Case decription: A 66-years-old woman presented with acute COVID-19 infection and primary adrenal insufficiency due to bilateral adrenal hemorrhage (BAH). She had also a renal vein thrombosis. Her past medical history revealed primary antiphospholipid syndrome (APLS). 4 weeks after discharge she had no signs of COVID-19 infection and her PCR test for COVID-19 was negative, but she still needed glucocorticoid and mineralocorticoid replacement therapy. The combination of APLS and COVID-19 was probably responsible of the adrenal event as a "two-hit" mechanism.
Conclusions: COVID-19 infection is associated with coagulopathy and thromboembolic events, including BAH. Adrenal insufficiency is life threatening, therefore we suggest to consider performing early adrenal axis testing for COVID-19 patients with clinical suspicion of adrenal insufficiency.
Keywords: Adrenal hemorrhage; Adrenal insufficiency; Antiphospholipid syndrome; COVID-19; Renal vein thrombosis.