ArticleAACE endocrinology and diabetes
Bilateral Adrenal Hemorrhage and Acute Adrenal Insufficiency Secondary to Heparin-Induced Thrombocytopenia After Coronary Artery Bypass Graft Surgery.
Article in AACE endocrinology and diabetes. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background/Objective: Adrenal insufficiency (AI) secondary to bilateral adrenal hemorrhage (BAH) from heparin-induced thrombocytopenia (HIT) is rare; only 3 instances of such cases were reported after coronary artery bypass graft surgery (CABG). We report a case of AI due to BAH from HIT after an elective CABG. Case Description: A 56-year-old male with a history of diabetes and multivessel coronary artery disease underwent CABG a week ago presented with abdominal pain. Labs showed leukocytosis, hyperglycemia, elevated anion gap, and positive serum ketones. Intravenous insulin with empirical antibiotics was started. Platelet decline was noticed from 154 000/uL to 39 000/uL on the following days, along with fever, hypotension, altered mentation, hyponatremia, and abdominal pain. A computed tomography scan of the abdomen showed BAH. Primary AI was confirmed with a cosyntropin stimulation test, and HIT was diagnosed with Heparin-PF4 IgG assay and serotonin release assay. His symptoms improved after hydrocortisone treatment. Discussion: AI secondary to BAH from HIT is a rare complication, with most cases reported after orthopedic surgeries. Symptoms of AI are vague and similar to sepsis. If hyponatremia, and gastrointestinal symptoms are noticed, adrenal insufficiency should be suspected, and early stress dose steroid treatment should be considered. Steroid treatment in such cases has shown to improve survival. Conclusion: The symptoms of adrenal insufficiency are nonspecific and could be similar to sepsis. Electrolyte abnormalities and gastrointestinal symptoms could be hints for adrenal insufficiency, especially if risks for adrenal hemorrhage are present. Early stress dose treatment in such cases has shown a survival benefit.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.