Adrenal hemorrhage
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Synonyms and keywords: Waterhouse-Friderichsen syndrome (WFS); hemorrhagic adrenalitis
Overview
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Overview
Adrenal hemorrhage is massive, usually bilateral, hemorrhage into the adrenal glands caused by fulminant meningococcemia.[1] WFS is characterized by overwhelming bacterial infection, rapidly progressive hypotension leading to shock, disseminated intravascular coagulation (DIC) with widespread purpura, particularly of the skin, and rapidly developing adrenocortical insufficiency associated with massive bilateral adrenal hemorrhage.
References
- ↑ Kumar V, Abbas A, Fausto N (2005). Robins and Coltran: Pathological Basis of Disease (7th ed.). Elsevier. pp. pp. 1214&ndash, 5. ISBN 978-0721601878.
Historical Perspective
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
Waterhouse-Friderichsen syndrome is named after Rupert Waterhouse (1873–1958), an English physician, and Carl Friderichsen (1886–1979), a Danish pediatrician, who wrote papers on the syndrome, which had been previously described.[1][2]
References
- ↑ Waterhouse R (1911). “A case of suprarenal apoplexy”. Lancet. 1: 577&ndash, 8. doi:10.1016/S0140-6736(01)60988-7.
- ↑ Friderichsen C (1918). “Nebennierenapoplexie bei kleinen Kindern”. Jahrb Kinderheilk. 87: 109&ndash, 25.
Classification
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References
Pathophysiology
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Overview
WFS can also be caused by Streptococcus pneumoniae infections, a common bacterial pathogen typically associated with meningitis in the adult and elderly population. Staphylococcus aureus has recently also been implicated in pediatric WFS.[1]
References
- ↑ Adem P, Montgomery C, Husain A, Koogler T, Arangelovich V, Humilier M, Boyle-Vavra S, Daum R (2005). “Staphylococcus aureus sepsis and the Waterhouse-Friderichsen syndrome in children”. N Engl J Med. 353 (12): 1245–51. PMID 16177250.
Causes
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
Causes
Adrenal hemorrhage occurs secondary to both traumatic conditions and atraumatic conditions. Atraumatic causes of adrenal hemorrhage include:
- Stress
- Hemorrhagic diathesis or coagulopathy
- Neonatal stress
- Underlying adrenal tumors
- Idiopathic disease
WFS can also be caused by Streptococcus pneumoniae infections, a common bacterial pathogen typically associated with meningitis in the adult and elderly population.[1] Staphylococcus aureus has recently also been implicated in pediatric WFS.[2]
References
- ↑ Kumar V, Abbas A, Fausto N (2005). Robins and Coltran: Pathological Basis of Disease (7th ed.). Elsevier. pp. pp. 1214&ndash, 5. ISBN 978-0721601878.
- ↑ Adem P, Montgomery C, Husain A, Koogler T, Arangelovich V, Humilier M, Boyle-Vavra S, Daum R (2005). “Staphylococcus aureus sepsis and the Waterhouse-Friderichsen syndrome in children”. N Engl J Med. 353 (12): 1245–51. PMID 16177250.
Differentiating Adrenal Hemorrhage from other Diseases
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Differentiating Adrenal hemorrhage from other Diseases
- Adrenal adenoma
- Adrenal carcinoma
- Adrenal metastases
- Adrenal myelolipoma
- Genitourinary tuberculosis
- Neuroblastoma
References
Epidemiology and Demographics
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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Epidemiology and Demographics
Meningococcus is another term for the bacterial species Neisseria meningitidis, which causes the type of meningitis which usually underlies this syndrome. Meningococcal meningitis occurs most commonly in children and young adults, and can occur in epidemics. In the United States it is the cause of about 20% of meningitis cases. At one time it was common among military recruits, but administration of the preventive meningococcal vaccine has greatly reduced this number. Freshman college students living in dormitory housing who have not been vaccinated are another risk group.
References
Risk Factors
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References
Screening
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References
Natural History, Complications and Prognosis
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References
Diagnosis
Diagnosis
History and Symptoms | Physical Examination | Laboratory Findings | Electrocardiogram | Chest X Ray | CT | MRI | Ultrasound | Other Imaging Studies | Other Diagnostic Studies
Treatment
Treatment
Medical Therapy | Surgery | Primary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies
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