Hemorragia adrenal bilateral en paciente recuperado de neumonía COVID-19 Grave: caso Radiológico / Bilateral adrenal hemorrhage after severe COVID-19 infection: report of one case

We report a 47-year-old male with a severe disease caused by COVID-19, who required mechanical ventilation for 18 ays. During the hospital stay he received dexamethasone and anticoagulation with heparin. After discharge a new chest CT scan showed homogeneous hypo vascular enlargement of both adrenal glands, not present in the initial imaging studies. It was interpreted as a subacute bilateral adrenal hemorrhage. The patient remained stable and without any complaint.

Hiperplasia suprarrenal macronodular bilateral independiente de ACTH: caso clínico / ACTH independent bilateral macronodular adrenal hyperplasia: report of one case

ACTH Independent cushing syndrome, involving both adrenal glands, represents a minority of endogenous hyperadrenocorticisms and is caused by infrequent diseases. ACTH independent macronodular adrenal hyperplasia (AIMAH) is one of them and is caused by aberrant cortical adrenal receptors expression that are able to stimulate cortisol secretion. We report a 62 years old male, presenting with hypertension, weight gain, urinary lithiasis and osteopenia. The diagnosis of Cushing's syndrome was made with a morning cortisol level after 1 mg nocturnal dexamethasone of 8.2 ug/dL. Urinary free 24 hour cortisol levels were normal, circadian rhythm of cortisol was maintained and ACTH was <5 pg/mL. Abdominal magnetic resonance imaging showed bilateral nodular adrenal enlargement. The functional study, looking for abnormal receptors, showed a potent cortisol secretory response after stimulation with vasopressin.

Adrenal hemorrhage due to vitamin-K deficiency.

Adrenal hemorrhage has many etiologies including bleeding diathesis. A 10-day-old female baby was admitted to our clinic with the complaint of abdominal distention. Hemorrhage was determined on the right adrenal gland with abdominal ultrasonography and computerized tomography. Laboratory investigations showed PT 44 sec and aPTT longer than one minute. This article reports here an infant diagnosed as adrenal hemorrhage due to Vitamin-K deficiency presenting as an abdominal mass.

Lesion quistica adrenal: hallazgo incidental / Cystic adrenal lesion. Incidental finding

Se presenta el hallazgo de una mesa adrenal quística unilateral no funcionante encontrada incidentalmente en una ecografía durante la evaluación de síntomas abdominales inespecíficos. Según la clasificación de quistes adrenales coresponde a un pseudoquiste multilocular con fibrosis y calcificación e la pared. La presencia de Factor VIII en el revestimiento de los quistes inidicaría un origen vascular de los mismos.

Adreno-cortical insufficiency

Adrenocortical insufficiency is not an uncommon disorder. It results from decreased corticosteroid hormones in the circulation, either due to complete or partial destruction of adrenal cortex or diseases of the hypothalamus pituitary axis. A variety of causes including infections, autoimmune disorders, tumourous infiltration and iatrogenic factors have been identified. The presentation of adrenocortical insufficiency may be insidious but Addisonian crisis is a potentially lethal condition which should be dealt with properly with rewarding results. A number of laboratory tests, simple and sophisticated have been used and applied to assess the adrenal functions are described. The management of Addisonian crisis and steroid replacement therapy, including their brand and generic names alongwith their relative potencies have also be discussed. It also includes the current concepts, controversies and the management of patients with adrenocortical insufficiency who either become pregnant or undergo major or minor surgery

Acometimento da supra-renal associado a paracoccidioidomicose / Adrenal gland involvement associated with paracoccidioidomycosis

A supra-renal foi estudada em 60 pacientes com paracoccidioidomicose. Dentre eles, 10 (16,7%) apresentavam alteraçöes anatômicas ou funcionais das supra-renais. As lesöes glandulares associaram-se à paracoccidioidomicose disseminada, com evoluçäo da doença de pelo menos cinco anos sem tratamento e com hipotensäo arterial sistêmica. Näo houve associaçäo entre alteraçöes anatomoclínicas supra-renais e alteraçöes radiológicas pulmonares. Esses dados revelam a importância da avaliaçäo sistemática da funçäo supra-renal em portadores de formas disseminadas da paracoccidioidomicose