Bilateral Adrenal Hemorrhage in Coronavirus Disease 2019 Patient: A Case Report.
J Clin Endocrinol Metab
; 105(12)2020 12 01.
Article
in En
| MEDLINE
| ID: mdl-32738040
ABSTRACT
CONTEXT Bilateral adrenal hemorrhage is a rare condition with potentially life-threatening consequences such as acute adrenal insufficiency. Early adrenal axis testing, as well as directed imaging, is crucial for immediate diagnosis and treatment. Coronavirus disease 2019 (COVID-19) has been associated with coagulopathy and thromboembolic events. CASE DESCRIPTION A 66-year-old woman presented with acute COVID-19 infection and primary adrenal insufficiency due to bilateral adrenal hemorrhage (BAH). She also had a renal vein thrombosis. Her past medical history revealed primary antiphospholipid syndrome (APLS). Four weeks after discharge she had no signs of COVID-19 infection and her polymerase chain reaction test for COVID-19 was negative, but she still needed glucocorticoid and mineralocorticoid replacement therapy. The combination of APLS and COVID-19 was probably responsible of the adrenal event as a "two-hit" mechanism. CONCLUSIONS:
COVID-19 infection is associated with coagulopathy and thromboembolic events, including BAH. Adrenal insufficiency is life threatening; therefore, we suggest that early adrenal axis testing for COVID-19 patients with clinical suspicion of adrenal insufficiency should be carried out.Key words
Full text:
1
Database:
MEDLINE
Main subject:
Pneumonia, Viral
/
Thrombosis
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Adrenal Gland Diseases
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Coronavirus Infections
/
Betacoronavirus
/
Hemorrhage
Type of study:
Prognostic_studies
Limits:
Aged
/
Female
/
Humans
Language:
En
Journal:
J Clin Endocrinol Metab
Year:
2020
Type:
Article
Affiliation country:
Israel