Acute adrenocortical insufficiency due to heparin-induced thrombocytopenia with subsequent bilateral haemorrhagic infarction of the adrenal glands.
A 56 year old male developed bilateral massive adrenal haemorrhage (BMAH) resulting in chronic adrenal insufficiency in the course of heparin-induced thrombocytopenia (HIT)-syndrome. Thrombosis of the central adrenal vein (CAV) with subsequent adrenal haemorrhagic infarction is the most probable cause of the rare association of HIT and BMAH. The exorbitantly high catecholamine plasma levels within the CAV in addition to immunogenic platelet activation are discussed as possible underlying pathophysiological mechanisms.
Weyrich
P
P
Medizinische Klinik und Poliklinik, Abteilung Innere Medizin IV, Eberhard-Karls-Universität Tübingen, Germany.
Balletshofer
B
B
Hoeft
S
S
Häring
H U
HU
Nawroth
P P
PP
D000307:Adrenal Gland Diseases / Q000139:chemically induced*; D000311:Adrenal Glands / Q000098:blood supply; D000309:Adrenal Insufficiency / Q000139:chemically induced*; D001281:Atrial Fibrillation / Q000188:drug therapy; D006470:Hemorrhage / Q000139:chemically induced*; D006493:Heparin / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D007238:Infarction / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D013921:Thrombocytopenia / Q000139:chemically induced*; D020246:Venous Thrombosis / Q000139:chemically induced
D006493:Heparin