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09-05-2024 | Systemic Lupus Erythematosus | ORIGINAL ARTICLE

Clinical characteristics of systemic lupus erythematosus patients with adrenal hemorrhage

Authors: Lan Gao, Lingling Zhang, Junli Luo, Guohua Zhang, Yawen Shen, Yuhua Wang, Mengtao Li

Published in: Clinical Rheumatology | Issue 7/2024

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Abstract

Introduction

Adrenal hemorrhage (AH) is a rare condition and severe cases can lead to acute adrenal insufficiency with potentially life-threatening consequences. AH can be caused by a variety of etiologic factors, including systemic lupus erythematosus and antiphospholipid syndrome (APS). The early identification and treatment of these patients improves their prognosis.

Objective

The aims of this study were to analyze and summarize the clinical characteristics of systemic lupus erythematosus patients with AH.

Methods

The clinical characteristics of 6 systemic lupus erythematosus patients complicated with AH admitted to Peking Union Medical College Hospital and Beijing Shijitan Hospital from May 2004 to April 2022 were retrospectively analyzed.

Results

The diagnosis of AH was based on computed tomography (CT) findings. Two patients had bilateral lesions, and the other 4 patients had unilateral lesions. The symptoms of adrenal insufficiency were observed in 2 patients. The frequent presenting symptoms were abdominal pain, lower abdominal distension, vomiting, weakness, fever, arthrodynia, and skin rash. Four patients had APS. Five patients (4 patients with APS and 1 patient without APS) had thromboembolic events. All patients received glucocorticoid and immunosuppressant therapy. Five patients were treated with anticoagulant therapy. Follow-up imaging examinations showed a partial or total regression of the lesions after treatment.

Conclusions

In the proper clinical setting, having high clinical suspicion for AH, early diagnosis and timely management is crucial to avoid life-threatening adrenal insufficiency.
Key Points
AH is a rare condition and severe cases may lead to death. It can be caused by a variety of etiologic factors, including SLE.
In patients with SLE, especially combined with APS, if they complain of abdominal pain, particularly when common gastrointestinal involvement is difficult to explain, a high index of clinical suspicion is needed for the diagnosis of AH.
Early identification of AH in SLE patients can improve their prognosis.
Literature
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Metadata
Title
Clinical characteristics of systemic lupus erythematosus patients with adrenal hemorrhage
Authors
Lan Gao
Lingling Zhang
Junli Luo
Guohua Zhang
Yawen Shen
Yuhua Wang
Mengtao Li
Publication date
09-05-2024
Publisher
Springer International Publishing
Published in
Clinical Rheumatology / Issue 7/2024
Print ISSN: 0770-3198
Electronic ISSN: 1434-9949
DOI
https://doi.org/10.1007/s10067-024-06938-z

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