Cases reported "Adrenal Gland Diseases"

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1/42. Haemorrhage into non-functioning adrenal cysts--report of two cases and review of the literature.

    Adrenal cysts are a rare condition and are usually non-functioning and asymptomatic. Most of the reported cases were incidental findings or discovered at autopsy. However, large cysts have a tendency to develop complications such as intracystic haemorrhage and rupture, which can present as an acute surgical emergency. We report two cases of adrenal cysts with intracystic haemorrhage. One patient presented with persistent non-specific upper abdominal pain, investigations with ultrasound (US) scan and computed tomographic (CT) scan revealed a left adrenal cyst and gallstones. Simultaneous cholecystectomy and adrenalectomy was performed with resultant relief of symptoms. The second patient presented with acute abdominal pain simulating acute surgical abdomen. Preoperative CT scan showed a large cystic lesion in the region of the tail of the pancreas with radiological evidence of haemorrhage but was unable to confirm its origin. The cyst was found to have arisen from the left adrenal gland at laparotomy; left adrenalectomy with complete excision of the cyst was done. histology showed pseudocyst with haemorrhage in both cases. Pseudocyst is the commonest histological type encountered clinically. We believe the second case is related to pregnancy and childbirth as the patient presented during puerperium and the cyst, even though very large in size (25 x 15 x 15 cm), was not noted during antenatal screening with US scan.
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ranking = 1
keywords = haemorrhage
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2/42. Neonatal cerebral venous thrombosis coexisting with bilateral adrenal hemorrhage.

    We report a case of severe perinatal asphyxia with both cerebral venous thrombosis and adrenal hemorrhage who survived with severe sequela including multicystic encephalomalasia, acquired microcephaly and blindness. Hematological investigations showed normal levels of anticardiolipin antibodies, protein c and S levels and activity, antithrombin iii levels. factor v Leiden mutation was negative. The adrenal hemorrhage resolved within three months with glucocorticoid therapy, the cerebral venous thrombosis resolved within two months without treatment. The literature on neonatal cerebral venous thrombosis is also reviewed.
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ranking = 0.00021653374563661
keywords = cerebral
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3/42. adult adrenal haemorrhage: an unrecognised complication of renal vein thrombosis.

    There are many predisposing factors for neonatal adrenal haemorrhage but the causative factors are different in adults. Several cases of neonatal adrenal haemorrhage have been reported in association with renal vein thrombosis. This complication has not been documented in the adults. The presence of an adrenal mass in the setting of renal vein thrombosis should raise the possibility of adrenal haemorrhage even though this is extremely uncommon in adults.
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ranking = 1.75
keywords = haemorrhage
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4/42. Acute adrenocortical insufficiency due to heparin-induced thrombocytopenia with subsequent bilateral haemorrhagic infarction of the adrenal glands.

    A 56 year old male developed bilateral massive adrenal haemorrhage (BMAH) resulting in chronic adrenal insufficiency in the course of heparin-induced thrombocytopenia (HIT)-syndrome. Thrombosis of the central adrenal vein (CAV) with subsequent adrenal haemorrhagic infarction is the most probable cause of the rare association of HIT and BMAH. The exorbitantly high catecholamine plasma levels within the CAV in addition to immunogenic platelet activation are discussed as possible underlying pathophysiological mechanisms.
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ranking = 0.25
keywords = haemorrhage
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5/42. waterhouse-friderichsen syndrome as a result of non-meningococcal infection.

    waterhouse-friderichsen syndrome--massive adrenal haemorrhage in the setting of overwhelming clinical sepsis--is usually taken at necropsy to indicate meningococcal infection, and may be the only evidence of this pathogen. This report describes three fatal cases of the syndrome in which the causative organism proved to be a streptococcus. The organisms were detected during routine coroners' autopsies with histology and microbiological investigations. In two cases, the syndrome followed streptococcus pneumoniae infection and in a third beta haemolytic streptococcus group A. Thus, adrenal haemorrhage alone cannot be taken to indicate meningococcal disease and other pathogens, particularly streptococcus, must be considered.
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ranking = 0.5
keywords = haemorrhage
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6/42. myoclonus and generalized digestive dysmotility in triple A syndrome with AAAS gene mutation.

    We report on the case of a 25-year-old woman with triple A syndrome and gene mutation, who, during the long follow-up period of 23 years, developed myoclonus of the face and the upper limbs (with normal brain magnetic resonance spectroscopy) and widespread digestive dysmotility, involving small bowels and gall bladder. These features, not previously described, illustrate an extension of the cerebral and digestive neurological involvement in this syndrome.
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ranking = 3.1554673522808E-5
keywords = cerebral, brain
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7/42. Bilateral benign haemorrhagic adrenal cysts in beckwith-wiedemann syndrome: case report.

    beckwith-wiedemann syndrome is the most common overgrowth malformation syndrome. The classical features include macrosomia, macroglossia, omphalocele and ear lobe anomalies. Among the associated adrenal anomalies, foetal cortical cytomegaly, outer cortical haemorrhage and unilateral benign cysts are well described. A term neonate was admitted with typical features of the syndrome. Radiological evaluation revealed a rare association of bilateral benign hamorrhagic adrenal cysts. Serial sonography confirmed hamorrhage into benign cysts and ruled out neoplasms. Only one similar case has been documented in the literature previously.
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ranking = 0.25
keywords = haemorrhage
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8/42. Bilateral adrenal haemorrhage and acute adrenal insufficiency in a blunt abdominal trauma: a case-report and literature review.

    Blunt abdominal trauma is frequently associated with adrenal haemorrhage, and is preferentially diagnosed by computed tomography scan. Lesions are mostly unilateral and asymptomatic and are therefore frequently overlooked. Bilateral haemorrhage, however, has a high mortality rate as a result of acute adrenal insufficiency. We report on a 30-year-old polytraumatic patient who developed cardiocirculatory arrest when all lesions were surgically controlled and stable and without evidence of a primary cardiac problem. autopsy revealed bilateral adrenal haemorrhage, leading to the diagnosis of acute adrenal insufficiency as the cause of death. We conclude that adrenal haemorrhage should be looked for in every polytrauma patient, and that although it is a rare occurrence, acute adrenal insufficiency caused by bilateral adrenal haemorrhage should be considered in every patient with unexplained cardiocirculatory failure. Such patients may benefit from the prompt administration of corticosteroid replacement, which can be life saving.
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ranking = 2.25
keywords = haemorrhage
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9/42. Neonatal adrenal abscess revisited: the importance of raised inflammatory markers.

    Adrenal abscesses rarely occur in neonates and usually present with non-specific signs and symptoms. Prompt diagnosis requires an index of suspicion. We describe right-sided adrenal haemorrhage and abscess formation in a newborn with hypoxic-ischaemic encephalopathy following maternal post-partum haemorrhage and sepsis with escherichia coli and enterococcus faecalis. Percutaneous drainage of the abscess identified an E. coli isolate identical to that in the mother plus candida albicans.
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ranking = 0.5
keywords = haemorrhage
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10/42. Bilateral adrenal infarction, hypoadrenalism and splinter haemorrhages in the 'primary' antiphospholipid syndrome.

    We describe a patient with a 3-year history of recurrent deep vein thromboses (DVT) of the lower limbs, who developed adrenal insufficiency following withdrawal of warfarin therapy. Multiple splinter haemorrhages of the nail beds were evident, simultaneous with the development of adrenal infarction in the absence of infective endocarditis. CT scans of the adrenal glands were consistent with bilateral adrenal infarctions. The patient had persistently high titres of IgG anticardiolipin antibodies (aCL) over the previous 4 years in the absence of antinuclear antibodies (ANA), antibodies to double stranded deoxyribonucleic acid (dsDNA) or extractable nuclear antigens (ENA). thrombocytopenia and an intermittently positive Coombs' test had been noted. Previous episodes of DVT were associated with inadequate warfarin control and a period of warfarin resistance. He conforms to a diagnosis of a 'primary' antiphospholipid syndrome.
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ranking = 1.25
keywords = haemorrhage
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