title: Bilateral adrenal gland haemorrhage: an unusual cause.
abstract: Our patient had drainage of a large amoebic liver abscess. This got complicated by a severe degree of hypotension, which required aggressive fluid resuscitation and hydrocortisone support. Computerised tomography (CT) of the abdomen revealed bilateral adrenal gland haemorrhage (BAH) resulting in primary adrenal gland failure, which was the cause for hypotension. Patient was on long-term warfarin for provoked deep vein thrombosis of lower limb, which was discontinued before the procedure. Thrombophilia profile indicated the presence of lupus anticoagulant factor with prolonged activated partial thromboplastin time (aPTT). Patient was discharged on lifelong warfarin. This case emphasises the need for strong clinical suspicion for diagnosing BAH, rare but life-threatening condition, and its association with amoebic liver abscess and anti-phospholipid antibody syndrome (APLS).
  
  
  CONCLUSIONS
  Recognition of BAH as a rare complication of sepsis.APLS can rarely cause BAH.
authors.affiliation: Department of Diabetes and Endocrinology The Townsville Hospital Townsville, Queensland Australia.
authors.forename: Durgesh
authors.initials: D
authors.lastname: Gowda
authors.affiliation: Department of Diabetes and Endocrinology The Townsville Hospital Townsville, Queensland Australia.
authors.forename: Vasant
authors.initials: V
authors.lastname: Shenoy
authors.affiliation: Department of Diabetes and Endocrinology The Townsville Hospital Townsville, Queensland Australia.
authors.forename: Usman
authors.initials: U
authors.lastname: Malabu
authors.affiliation: Department of Surgery The Townsville Hospital Townsville, Queensland Australia.
authors.forename: Donald
authors.initials: D
authors.lastname: Cameron
authors.affiliation: Department of Diabetes and Endocrinology The Townsville Hospital Townsville, Queensland Australia.
authors.forename: Kunwarjit
authors.initials: K
authors.lastname: Sangla