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| Content Provider | World Health Organization (WHO)-Global Index Medicus |
|---|---|
| Author | Godfrey, Rebecca Louise Clark, James Field, Benjamin |
| Description | Author Affiliation: Godfrey RL ( Frimley Health NHS Foundation Trust, Frimley, UK.); Clark J ( Surrey & Sussex Healthcare NHS Trust, Redhill, UK.); Field B ( Surrey & Sussex Healthcare NHS Trust, Redhill, UK.) |
| Abstract | A 68-year-old woman with antiphospholipid syndrome presented with a 3-day history of bilateral loin pain, vomiting, fever and confusion. On examination she was febrile, hypotensive and tachycardic. Investigations revealed raised inflammatory markers, renal impairment and hyponatraemia. Abdominal ultrasound revealed two well-defined heterogeneous areas bilaterally in the region of the adrenal glands. This prompted serum cortisol measurement and a CT of the abdomen. Cortisol was low in the context of sepsis at 48â nmol/L, and CT confirmed bilateral heterogeneous adrenal pathology. The patient was managed for septic shock and adrenal insufficiency. She was recognised to have several risk factors for haemorrhagic infarction of the adrenals: antiphospholipid syndrome, sepsis, postoperative state and anticoagulant therapy. She was discharged well on glucocorticoid and mineralocorticoid therapy and a repeat CT at 4â weeks confirmed the diagnosis of bilateral adrenal infarct and haemorrhage. |
| Volume Number | 2014 |
| e-ISSN | 1757790X |
| Journal | BMJ Case Reports |
| Language | English |
| Publisher | BMJ Publishing Group Ltd. |
| Publisher Place | Great Britain (UK) |
| Access Restriction | One Nation One Subscription (ONOS) |
| Subject Keyword | Adrenal Gland Diseases Etiology Adrenal Glands Blood Supply Antiphospholipid Syndrome Complications Hemorrhage Infarction Diagnosis Aged Diagnosis, Differential Female Humans Tomography, X-Ray Computed Case Reports Journal Article Multidisciplinary |
| Content Type | Text |
| Resource Type | Article |
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