肾上腺出血作为新型冠状病毒肺炎感染的一种并发症。
Adrenal haemorrhage as a complication of COVID-19 infection.
作者信息
Sharrack Noor, Baxter Conal Thomas, Paddock Michael, Uchegbu Elizabeth
机构信息
Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, West Yorkshire, UK
Department of Cardiology, Sheffield Teaching Hospitals NHS Foundation Trust Cardiothoracic Centre, Sheffield, South Yorkshire, UK.
出版信息
BMJ Case Rep. 2020 Nov 30;13(11):e239643. doi: 10.1136/bcr-2020-239643.
We report an unusual complication of COVID-19 infection in a 53-year-old Caucasian man. He presented with shortness of breath, fever and pleuritic chest pain. A CT pulmonary angiogram (CTPA) demonstrated acute bilateral pulmonary embolism and bilateral multifocal parenchymal ground glass change consistent with COVID-19 (SARS-CoV-2) infection. Right adrenal haemorrhage was suspected on the CTPA which was confirmed on triple-phase abdominal CT imaging. A short Synacthen test revealed normal adrenal function. He was treated initially with an intravenous heparin infusion, which was changed to apixaban with a planned outpatient review in 3 months' time. He made an uncomplicated recovery and was discharged. Follow-up imaging nearly 5 months later showed near complete resolution of the right adrenal haemorrhage with no CT evidence of an underlying adrenal lesion.
我们报告了一名53岁白人男性新冠肺炎感染的罕见并发症。他表现为呼吸急促、发热和胸膜炎性胸痛。胸部CT血管造影（CTPA）显示急性双侧肺栓塞以及与新冠肺炎（SARS-CoV-2）感染相符的双侧多灶性实质磨玻璃改变。CTPA怀疑右侧肾上腺出血，三相腹部CT成像证实了这一点。短程促肾上腺皮质激素试验显示肾上腺功能正常。他最初接受静脉肝素输注治疗，后改为阿哌沙班，并计划在3个月后进行门诊复查。他康复过程顺利并出院。近5个月后的随访成像显示右侧肾上腺出血几乎完全消退，CT未发现潜在肾上腺病变的证据。
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