[Frequency of adrenal hemorrhage in fatal forms of purpura fulminans in children. Etiopathogenic and therapeutic considerations].
Between 1971 and 1985, 43 children died of purpura fulminans in our intensive care unit: 11 had autopsy and adrenal haemorrhage was observed in 8 (73%). All these patients had an extensive purpura and a severe disseminated intravascular coagulation. Our series confirms the findings of previous studies: 69 autopsies showed 51 cases (74%) of macroscopic adrenal haemorrhage. Adrenal haemorrhage may be only one manifestation of multiple system organ failure consecutive to septic shock; however, its association with low plasma cortisol levels (as previously reported) suggests that glucocorticoid replacement therapy should be reconsidered in purpura fulminans.
Leclerc
F
F
Unité de réanimation infantile, Hôpital Calmette, Lille, France.
Delepoulle
F
F
Martinot
A
A
Diependaele
J F
JF
Houque
D
D
Hue
V
V
D000307:Adrenal Gland Diseases / Q000209:etiology*; D002648:Child; D002675:Child, Preschool; D004211:Disseminated Intravascular Coagulation / Q000150:complications; D006470:Hemorrhage / Q000209:etiology*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007223:Infant; D011693:Purpura / Q000150:complications* / Q000401:mortality; D012189:Retrospective Studies; D012772:Shock, Septic / Q000209:etiology*; D014884:Waterhouse-Friderichsen Syndrome / Q000150:complications
D006854:Hydrocortisone
Fréquence des hémorragies surrénaliennes au cours des formes fatales de purpura fulminans de l'enfant. Considérations étio-pathogéniques et thérapeutiques.