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Case Reports
. 2015 Feb 3:9:18.
doi: 10.1186/1752-1947-9-18.

Restoration of adrenal function after bilateral adrenal damage due to heparin-induced thrombocytopenia (HIT): a case report

Jaafar Jaafar  1 , Françoise Boehlen  2 , Jacques Philippe  3 , Mathieu Nendaz  4
Affiliations
Case Reports

Restoration of adrenal function after bilateral adrenal damage due to heparin-induced thrombocytopenia (HIT): a case report

Jaafar Jaafar et al. J Med Case Rep. .

Abstract

Introduction: Patients with bilateral adrenal damage due to heparin-induced thrombocytopenia usually need lifelong steroid substitution. So far, no data exists about the natural evolution of such a condition, especially about adrenal function recovery and the real need for lifelong steroids.

Case presentation: An 81-year-old Caucasian woman with bilateral adrenal damage due to heparin-induced thrombocytopenia presented with fever and severe hypotension. Adrenal failure was confirmed biologically and radiologically. She eventually recovered her adrenal function, allowing for steroid withdrawal.

Conclusions: This case report addresses the different mechanisms of adrenal damage due to heparin-induced thrombocytopenia and its natural evolution with potential recovery. This should encourage clinicians to evaluate the real necessity for lifelong corticosteroid substitution in such a condition.

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Figures

Figure 1
Figure 1
Platelet count (G/L) during the first 20 days of hospitalization and its relation to heparin use.
Figure 2
Figure 2
Abdominal computed tomography scans. (A) Abdominal computed tomography scan on day 3 showing normal adrenal glands. (B) Abdominal computed tomography scan on day 14 showing infiltration with increased adrenal gland volume. (C) Abdominal computed tomography scan on day 21 showing bilateral adrenal hemorrhagic infarction. (D) Abdominal computed tomography scan on day 435 showing small atrophic adrenal glands.
Figure 3
Figure 3
Hydrocortisone doses and blood cortisol levels before and after adrenocorticotropic hormone tests, over 600 days.
See this image and copyright information in PMC

References

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