Adrenal Hemorrhage, a Simple Guide to the Condition, Diagnosis, Treatment and Related Conditions

This book describes Adrenal Hemorrhage, Diagnosis and Treatment and Related DiseasesAn adrenal hemorrhage is bleeding within the adrenal gland, the triangular-shaped gland on top of each kidney. Adrenal hemorrhage also termed adrenal apoplexy is a relatively rare disorder with an inconsistent and nonspecific manifestation that may cause acute adrenal crisis, shock and death unless it is diagnosed promptly and treated properly.
Patients with adrenal hemorrhage may die due to underlying disease or diseases linked with adrenal hemorrhage, in spite of treatment with stress-dose glucocorticoids. Overall, adrenal hemorrhage is linked with a 15% mortality rate, which differs based on the severity of the underlying illness predisposing to adrenal hemorrhage. Patients with Waterhouse-Friderichsen syndrome (adrenal hemorrhage happening in sepsis, most often meningococcal) have a 55-60% mortality rate.
While adrenal hemorrhage may happen in people of any age, most patients with non-traumatic, excessive, bilateral adrenal hemorrhage are aged 40-80 years at the moment of the acute event. Patients with traumatic adrenal hemorrhage normally are in the 2nd to 3rd decade of life. Most patients with Waterhouse-Friderichsen syndrome are in the children age group, even though adults have seldom been affected.
Adrenal hemorrhage in neonates is a well-described disorder and has even been diagnosed in uterus. Chronic adrenal insufficiency happens in most patients who survive extensive, bilateral adrenal hemorrhage, requiring long-term glucocorticoid replacement. In contrast, the necessity for mineralocorticoid replacement is inconsistent. Androgen replacement treatment may also be helpful in women with chronic adrenal insufficiency.
It can happen in a person of any age, but is more often seen in the 40 to 80 year age group. The disorder at times is not diagnosed and is only detected upon conducting an autopsy. The bleeding may be present only in one adrenal gland (unilateral) or on both sides (bilateral). When bleeding happens on one side, the other gland is able to balance with production and secretion of the necessary adrenal hormones.
It is evaluated that some 15% of people who die of shock show evidence of adrenal hemorrhage on both sides (bilateral). The causes of both unilateral (one-sided) and bilateral (both sides) adrenal hemorrhage may have frequent features. Unilateral Adrenal Hemorrhage1. Blunt trauma2. Abdominal surgery of organs or structures near the adrenal gland3. Cancer of the adrenal gland4. Long term use of NSAIDs (non-steroidal anti-inflammatory drugs)5.
Pregnancy without complications6. Unknown causes (idiopathic)Bilateral Adrenal Hemorrhage1. Infections2. Heart diseases like congestive cardiac failure or a myocardial infarction (heart attack).3. Cirrhosis (liver)4. Pancreatitis5. Inflammatory bowel disease6. Severe abdominal injury7. Pregnancy complications8. Surgery like coronary artery bypass, hip replacement and intracranial procedures.9. Bleeding disorders like thrombocytopenia and use of blood thinning drugs.10.
Vascular disorders including deep venous thrombosis11. Cancer spread from another site12. Waterhouse-Friderichsen syndromeTABLE OF CONTENTIntroductionChapter 1 Adrenal HemorrhageChapter 2 CausesChapter 3 SymptomsChapter 4 DiagnosisChapter 5 TreatmentChapter 6 PrognosisChapter 7 Adrenal CrisisChapter 8 Life and Death of Adrenal GlandEpilogue