A Case Of Bilateral Adrenal Hemorrhage and Subsequent Adrenal Crisis due to Heparin-Induced Thrombocytopenia

ABSTRACT Objective: To discuss a case of adrenal insufficiency (AI) caused by heparin-induced thrombocytopenia (HIT) and subsequent adrenal hemorrhage. Methods: We describe the case of a patient who developed postoperative HIT, which went undetected until the patient presented with fulminant adrenal crisis. We provide here an overview of the work-up, diagnosis, and treatment of HIT-associated AI. Results: HIT is a rare cause of bilateral adrenal hemorrhage, and subsequent AI secondary to HIT is often clinically unsuspected until overt hemodynamic collapse occurs. Conclusions: Lack of early detection and appropriate treatment of HIT-induced AI can lead to significant patient morbidity and mortality. Awareness of this clinical condition is key to early recognition and treatment. Abbreviations: AI adrenal insufficiency CABG coronary artery bypass grafting CT computed tomography HIT heparin-induced thrombocytopenia