title: [Bilateral adrenal hemorrhage revealing hyperhomocysteinemia].
abstract: BACKGROUND
  Bilateral adrenal hemorrhage remains a rare disease. It has several etiologies, and clinical presentation is not specific.
  
  
  METHODS
  We report a 45-year old man without known prothrombotic factor who presented with acute left sided abdominal pain left revealing a bilateral adrenal hemorrhage. The diagnostic work-up identified a significant hyperhomocysteinemia associated with a previously undiagnosed homozygous mutation of the 5,10 methylene-tetrahydrofolate reductase gene. The outcome was associated with the occurrence of an adrenal insufficiency.
authors.affiliation: Service de médecine A, hôpital Louis-Pasteur, hôpitaux de Chartres, 4, rue Claude-Bernard, 28630 Le Coudray, France. Electronic address: luwawumbimbamurphy@yahoo.fr.
authors.forename: M
authors.initials: M
authors.lastname: Luwawu Mbimba
authors.affiliation: Service de médecine A, hôpital Louis-Pasteur, hôpitaux de Chartres, 4, rue Claude-Bernard, 28630 Le Coudray, France.
authors.forename: A
authors.initials: A
authors.lastname: Monier
authors.affiliation: Service de médecine gastro-entérologique, centre hospitalier de Coutances, 50200 Coutances France.
authors.forename: C
authors.initials: C
authors.lastname: Tchanou
authors.affiliation: Service de médecine A, hôpital Louis-Pasteur, hôpitaux de Chartres, 4, rue Claude-Bernard, 28630 Le Coudray, France.
authors.forename: L
authors.initials: L
authors.lastname: Bernard
authors.affiliation: Service de médecine A, hôpital Louis-Pasteur, hôpitaux de Chartres, 4, rue Claude-Bernard, 28630 Le Coudray, France.
authors.forename: C
authors.initials: C
authors.lastname: Vincent Dejean
mesh_terms: D000307:Adrenal Gland Diseases / Q000150:complications / Q000175:diagnosis*; D003937:Diagnosis, Differential; D006470:Hemorrhage / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D020138:Hyperhomocysteinemia / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged
keywords: Adrenal hemorrhage; Adrenal insufficiency; Hyperhomocysteinemia; Hyperhomocystéinémie; Hémorragie surrénalienne; Insuffisance surrénalienne; MTHFR homozygous mutation; Mutation homozygote de la MTHFR