Adrenal hemorrhage during anticoagulant therapy

Abstract

In 6 cases of adrenal hemorrhage during anticoagulant therapy studied and 25 cases reported in the English literature, the most common symptoms were abdominal and back pain, anorexia, nausea and vomiting. Frequent signs are hypotension, fever and disturbed sensorium. Helpful laboratory findings are depressed urine corticosteroid levels, elevated total eosinophil count, elevated white blood cell count, reduced serum Na and chloride levels and elevated serum level. Pathogenetic mechanisms for this syndrome probably include the increasedcapillary-fragllltj of oldage, shock resultlngfrom the primary pathologic process, adrenal vein thrombosis, andadrenal cortical degeneration. Coagulation values outside the therapeutic range are more common than has been suspected in the past. This too may be important in the pathogenesis of this syndrome..