Jaafar Jaafar, Boehlen Françoise, Philippe Jacques, Nendaz Mathieu
Department of Internal Medicine, Geneva University Hospitals and Faculty of Medicine, Gabrielle-Perret-Gentil 4, Geneva, 1211, Switzerland.
Division of Angiology and Hemostasis, Geneva University Hospitals and Faculty of Medicine, Gabrielle-Perret-Gentil 4, Geneva, 1211, Switzerland.
J Med Case Rep. 2015 Feb 3;9:18. doi: 10.1186/1752-1947-9-18.
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.
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.
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.
因肝素诱导的血小板减少症导致双侧肾上腺损伤的患者通常需要终身使用类固醇替代治疗。迄今为止，尚无关于这种情况自然演变的数据，尤其是关于肾上腺功能恢复以及终身使用类固醇的实际必要性。
一名81岁因肝素诱导的血小板减少症导致双侧肾上腺损伤的白种女性出现发热和严重低血压。经生物学和放射学检查确诊为肾上腺功能衰竭。她最终恢复了肾上腺功能，得以停用类固醇。
本病例报告阐述了肝素诱导的血小板减少症导致肾上腺损伤的不同机制及其具有潜在恢复可能的自然演变过程。这应促使临床医生评估在这种情况下终身使用皮质类固醇替代治疗的实际必要性。
