title: Restoration of adrenal function after bilateral adrenal damage due to heparin-induced thrombocytopenia (HIT): a case report.
abstract: BACKGROUND
  Patients with bilateral adrenal damage due to heparin-induced thrombocytopenia usually need lifelong steroid substitution. So far, no data exists about the natural evolution of such a condition, especially about adrenal function recovery and the real need for lifelong steroids.
  
  
  METHODS
  An 81-year-old Caucasian woman with bilateral adrenal damage due to heparin-induced thrombocytopenia presented with fever and severe hypotension. Adrenal failure was confirmed biologically and radiologically. She eventually recovered her adrenal function, allowing for steroid withdrawal.
  
  
  CONCLUSIONS
  This case report addresses the different mechanisms of adrenal damage due to heparin-induced thrombocytopenia and its natural evolution with potential recovery. This should encourage clinicians to evaluate the real necessity for lifelong corticosteroid substitution in such a condition.
authors: Department of Internal Medicine, Geneva University Hospitals and Faculty of Medicine, Gabrielle-Perret-Gentil 4, Geneva, 1211, Switzerland. jaafar.jaafar@hcuge.ch.
authors: Jaafar
authors: J
authors: Jaafar
authors: Division of Angiology and Hemostasis, Geneva University Hospitals and Faculty of Medicine, Gabrielle-Perret-Gentil 4, Geneva, 1211, Switzerland. francoise.boehlen@hcuge.ch.
authors: Françoise
authors: F
authors: Boehlen
authors: Division of Endocrinology and Diabetology, Geneva University Hospitals and Faculty of Medicine, Gabrielle-Perret-Gentil 4, Geneva, 1211, Switzerland. jacques.philippe@hcuge.ch.
authors: Jacques
authors: J
authors: Philippe
authors: Department of Internal Medicine, Geneva University Hospitals and Faculty of Medicine, Gabrielle-Perret-Gentil 4, Geneva, 1211, Switzerland. mathieu.nendaz@hcuge.ch.
authors: Mathieu
authors: M
authors: Nendaz
mesh_terms: D000311:Adrenal Glands / Q000187:drug effects* / Q000503:physiopathology*; D000309:Adrenal Insufficiency / Q000139:chemically induced* / Q000188:drug therapy; D000369:Aged, 80 and over; D000925:Anticoagulants / Q000009:adverse effects*; D005260:Female; D006493:Heparin / Q000009:adverse effects*; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D013921:Thrombocytopenia / Q000139:chemically induced* / Q000188:drug therapy
chemical_list: D000925:Anticoagulants; D006493:Heparin; D006854:Hydrocortisone
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