Anticoagulant Therapy and Acute Adrenal Insufficiency
Authors: Gary I. Portnay, Apostolos G. Vagenakis, Lewis E. Braverman, Sergio I. Cervi-Skinner
Journal: Annals of Internal Medicine (1974)

Letters1 July 1974Anticoagulant Therapy and Acute Adrenal InsufficiencyGARY I. PORTNAY, M.D., APOSTOLOS G. VAGENAKIS, M.D., LEWIS E. BRAVERMAN, M.D., F.A.C.P., SERGIO I. CERVI-SKINNER, M.D.GARY I. PORTNAY, M.D.Search for more papers by this author, APOSTOLOS G. VAGENAKIS, M.D.Search for more papers by this author, LEWIS E. BRAVERMAN, M.D., F.A.C.P.Search for more papers by this author, SERGIO I. CERVI-SKINNER, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-81-1-115 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptTo the editor: Bilateral adrenal hemorrhage with resultant acute adrenal insufficiency has been recognized as a fatal complication of anticoagulant therapy (1, 2). Only rarely has this medical emergency been recognized before death (3). We recently observed four patients who developed adrenal insufficiency while receiving anticoagulant therapy. Three of these patients survived after adequate corticosteroid replacement therapy.Four patients (Table 1) admitted to the hospital (1968 to 1972) developed acute symptoms while receiving anticoagulant therapy. These symptoms in Patients 1 and 3 were abdominal pain with radiation to the flanks. Patient 2 had a syncopal episode secondary to hypotension. Patient...References1. VERDONK G: Bijnierapoplexie bij cen mes heparine behandelde patiente. Ned Tijdschr Geneeskd 91:2409-2412, 1947 Google Scholar2. AMADOR E: Adrenal hemorrhage during anticoagulant therapy. A clinical and pathological study of ten cases. Ann Intern Med 63:559-571, 1965 LinkGoogle Scholar3. KLASSENMURPHY JB: Survival after bilateral adrenal hemorrhage during heparin therapy. Can Med Assoc J 97:1162-1165, 1967 MedlineGoogle Scholar4. DREHERMACINDOEMAGNIN WJG: Acute adrenal insufficiency secondary to anticoagulant therapy. Wis Med J 70:144-147, 1971 MedlineGoogle Scholar5. HAZARDRICORDEAUPRUDHOMMEAUX JGJ: Insuffisance surrénale aiguë puis chronique survenue au cours d'un traitement anticoagulant. Presse Med 79:962-964, 1971 MedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAffiliations: New England Medical Center Tufts Medical School Boston, Massachusetts PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byBilateral massive adrenal hemorrhageHeparin-Related Thrombocytopenia and Adrenal Hemorrhagic Necrosis Following Aortic Surgery10 Endocrine emergencies in pregnancyBilateral Massive Adrenal Hemorrhage: Early Recognition and TreatmentR. Harsha Rao, MD, Anthony H. Vagnucci, MD, Janet A. Amico, MDHématomes des surrénales et héparineAn unusual cause of an acute surgical abdomenAddison’s DiseasePulmonary thromboembolic diseaseAdrenal insufficiency and bilateral adrenal enlargement: demonstration by computed tomography.BILATERAL ADRENAL HEMORRHAGE: A COMPLICATION OF PROPHYLACTIC ANTICOAGULATION 1 July 1974Volume 81, Issue 1Page: 115-115KeywordsAbdominal painAnticoagulant therapyCorticosteroid therapyHemorrhageHypotensionSyncope Issue Published: 1 July 1974 PDF downloadLoading ...