Bilateral Adrenal Hemorrhage in a Patient with Antiphospholipid Syndrome during Chronic Graft-versus-host Disease

We present the case of a 56-year-old man with an upper respiratory infection followed by fatigue, hypotension, and hyponatremia. Bilateral adrenal hemorrhage was confirmed, based on T2-weighted magnetic resonance imaging. The patient had previously undergone allogeneic hematopoietic stem cell transp...

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Autores principales: Minami, Mariko, Muta, Tsuyoshi, Adachi, Masahiro, Higuchi, Masakazu, Aoki, Kenichi, Ogawa, Ryosuke
Formato: Online Artículo Texto
Lenguaje:English
Publicado: The Japanese Society of Internal Medicine 2017
Materias:
Case Report
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995706/
https://www.ncbi.nlm.nih.gov/pubmed/29279512
http://dx.doi.org/10.2169/internalmedicine.9820-17
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author Minami, Mariko
Muta, Tsuyoshi
Adachi, Masahiro
Higuchi, Masakazu
Aoki, Kenichi
Ogawa, Ryosuke
author_facet Minami, Mariko
Muta, Tsuyoshi
Adachi, Masahiro
Higuchi, Masakazu
Aoki, Kenichi
Ogawa, Ryosuke
author_sort Minami, Mariko
collection PubMed
description We present the case of a 56-year-old man with an upper respiratory infection followed by fatigue, hypotension, and hyponatremia. Bilateral adrenal hemorrhage was confirmed, based on T2-weighted magnetic resonance imaging. The patient had previously undergone allogeneic hematopoietic stem cell transplantation and had been diagnosed with antiphospholipid syndrome (APS) during the development of chronic graft-versus-host disease. A prompt diagnosis and steroid replacement, in addition to anticoagulant therapy, resulted in a favorable outcome. Once the diagnosis of APS has been confirmed, which might be the sign of bilateral adrenal hemorrhage, the initial manifestations of adrenal insufficiency should never be overlooked.
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spelling pubmed-59957062018-06-13 Bilateral Adrenal Hemorrhage in a Patient with Antiphospholipid Syndrome during Chronic Graft-versus-host Disease Minami, Mariko Muta, Tsuyoshi Adachi, Masahiro Higuchi, Masakazu Aoki, Kenichi Ogawa, Ryosuke Intern Med Case Report We present the case of a 56-year-old man with an upper respiratory infection followed by fatigue, hypotension, and hyponatremia. Bilateral adrenal hemorrhage was confirmed, based on T2-weighted magnetic resonance imaging. The patient had previously undergone allogeneic hematopoietic stem cell transplantation and had been diagnosed with antiphospholipid syndrome (APS) during the development of chronic graft-versus-host disease. A prompt diagnosis and steroid replacement, in addition to anticoagulant therapy, resulted in a favorable outcome. Once the diagnosis of APS has been confirmed, which might be the sign of bilateral adrenal hemorrhage, the initial manifestations of adrenal insufficiency should never be overlooked. The Japanese Society of Internal Medicine 2017-12-27 2018-05-15 /pmc/articles/PMC5995706/ /pubmed/29279512 http://dx.doi.org/10.2169/internalmedicine.9820-17 Text en Copyright © 2018 by The Japanese Society of Internal Medicine https://creativecommons.org/licenses/by-nc-nd/4.0/ The Internal Medicine is an Open Access article distributed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. To view the details of this license, please visit (https://creativecommons.org/licenses/by-nc-nd/4.0/).
spellingShingle Case Report
Minami, Mariko
Muta, Tsuyoshi
Adachi, Masahiro
Higuchi, Masakazu
Aoki, Kenichi
Ogawa, Ryosuke
Bilateral Adrenal Hemorrhage in a Patient with Antiphospholipid Syndrome during Chronic Graft-versus-host Disease
title Bilateral Adrenal Hemorrhage in a Patient with Antiphospholipid Syndrome during Chronic Graft-versus-host Disease
title_full Bilateral Adrenal Hemorrhage in a Patient with Antiphospholipid Syndrome during Chronic Graft-versus-host Disease
title_fullStr Bilateral Adrenal Hemorrhage in a Patient with Antiphospholipid Syndrome during Chronic Graft-versus-host Disease
title_full_unstemmed Bilateral Adrenal Hemorrhage in a Patient with Antiphospholipid Syndrome during Chronic Graft-versus-host Disease
title_short Bilateral Adrenal Hemorrhage in a Patient with Antiphospholipid Syndrome during Chronic Graft-versus-host Disease
title_sort bilateral adrenal hemorrhage in a patient with antiphospholipid syndrome during chronic graft-versus-host disease
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5995706/
https://www.ncbi.nlm.nih.gov/pubmed/29279512
http://dx.doi.org/10.2169/internalmedicine.9820-17
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