[Adrenal hemorrhage acutised by adrenocorticotropin hormone].
OBJECTIVE
Many spontaneous adrenal hematomas have been observed in patients being treated by Synacthène. The purpose of this study is to define how to take those patients in charge on a short-, mid- and long-term.


METHODS
From January 2000 to December 2008, five patients (four males and one female), mean age 47, were taken in charge in our service for spontaneous adrenal hematomas. All those patients had been treated with Synacthène for a mid-sciatic pain for 72 hours. We associated a clinical, endocrine and radiologic staging to treat those patients.


RESULTS
Four patients underwent a watchful waiting, only one patient needed surgery. No adrenal tumor was ever found during the mean two years follow-up (one to four). Two patients suffered of the condition of the antiphospholipid syndrome.


CONCLUSIONS
Spontaneous adrenal hematomas are a most uncommon pathology. The clinical attitude has thus to be defined clearly. The patient must be under close clinical evaluation. Biological and morphological parameters have to be often repeated. An adrenal tumor has to be excluded by the evaluation, as that tumor could be secreting or could not be secreting. Antiphospholipid syndrome must also be excluded.
Surga
N
N
Services d'urologie-transplantation, CHU hôpital Sud, université Picardie-Jules-Verne, avenue René-Laënnec, Salouël, 80054 Amiens cedex 1,France.
Makdassi
R
R
Choukroun
G
G
Vandwalle
J
J
Petit
J
J
Saint
F
F
D000307:Adrenal Gland Diseases / Q000139:chemically induced* / Q000628:therapy; D000328:Adult; D000368:Aged; D003366:Cosyntropin / Q000009:adverse effects*; D003663:Decision Trees; D005260:Female; D006406:Hematoma / Q000139:chemically induced* / Q000628:therapy; D006470:Hemorrhage / Q000139:chemically induced* / Q000628:therapy; D006728:Hormones / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies
D006728:Hormones; D003366:Cosyntropin; C006418:adrenocorticotropin zinc