title: Bilateral adrenal gland hemorrhage in a patient treated with rivaroxaban.
abstract: This is the report of a case of a 63-year-old woman, with a history of recurrent deep vein thrombosis, who was admitted with abdominal pain and diagnosed with bilateral adrenal hemorrhage, resulting in acute adrenal insufficiency. Several risk factors for adrenal hemorrhage were present: stress because of infection, treatment with the factor Xa-inhibitor rivaroxaban and the presence of antiphospholipid antibodies. Venous thrombosis of the adrenal glands with subsequent hemorrhagic infarction is a possible mechanism. It is currently unclear if patients with antiphospholipid syndrome can be treated effectively and safely with a nonvitamin K-antagonist oral anticoagulant.
authors.affiliation: aDepartment of Medicine bDepartment of Clinical Biochemistry, Hospital Unit West, Herning cDepartment of Biomedicine, Aarhus University, Aarhus, Denmark.
authors.forename: Willemijn
authors.initials: W
authors.lastname: Comuth
authors.forename: Jens J
authors.initials: JJ
authors.lastname: Christiansen
authors.forename: Anna-Marie
authors.initials: AM
authors.lastname: Bloch-Münster
authors.forename: Steen
authors.initials: S
authors.lastname: Husted
mesh_terms: D000307:Adrenal Gland Diseases / Q000139:chemically induced*; D065427:Factor Xa Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D005260:Female; D006470:Hemorrhage / Q000139:chemically induced*; D006801:Humans; D008875:Middle Aged; D000069552:Rivaroxaban / Q000008:administration & dosage / Q000009:adverse effects*
chemical_list: D065427:Factor Xa Inhibitors; D000069552:Rivaroxaban