Hemorragia suprarrenal unilateral asociada a crisis hipertensiva en un paciente antiagregado

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Abstract

Objetivo: Presentación de un caso de hemorragia suprarrenal no traumática en un paciente antiagregado. Métodos: El paciente fue ingresado en la Unidad de Cuidados Intensivos por una crisis hipertensiva no controlada. Se descartó analíticamente la existencia de un feocromocitoma y se practicó una suprarrenalectomía diferida. Resultados: El examen histológico de la glándula mostró una extensa necrosis hemorrágica. Conclusiones: La asociación de hipertensión arterial y hemorragia suprarrenal no es diagnóstica de feocromocitoma.

Translated abstract

Objective: We report a case of non-traumatic adrenal hemorrhage in a man with antiplatelet treatment. Methods: The patient was admitted to the Critical Care Unit because of a non-controlled hypertensive crisis. Pheochromocytoma was analytically excluded. The patient underwent a delayed adrenalectomy. Results: Pathologic study of the specimen showed a wide hemorrhagic necrosis. Conclusions: Association of high blood pressure and adrenal hemorrhage is not pathognomonic of pheochromocytoma.

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Most cited references 16

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Aspirin for the primary prevention of cardiovascular events in women and men: a sex-specific meta-analysis of randomized controlled trials.

Jeffrey Berger, Maria C. Roncaglioni, Fausto Avanzini … (2006)

Aspirin therapy reduces the risk of cardiovascular disease in adults who are at increased risk. However, it is unclear if women derive the same benefit as men. To determine if the benefits and risks of aspirin treatment in the primary prevention of cardiovascular disease vary by sex. MEDLINE and the Cochrane Central Register of Controlled Trials databases (1966 to March 2005), bibliographies of retrieved trials, and reports presented at major scientific meetings. Eligible studies were prospective, randomized controlled trials of aspirin therapy in participants without cardiovascular disease that reported data on myocardial infarction (MI), stroke, and cardiovascular mortality. Six trials with a total of 95 456 individuals were identified; 3 trials included only men, 1 included only women, and 2 included both sexes. Studies were reviewed to determine the number of patients randomized, mean duration of follow-up, and end points (a composite of cardiovascular events [nonfatal MI, nonfatal stroke, and cardiovascular mortality], each of these individual components separately, and major bleeding). Among 51,342 women, there were 1285 major cardiovascular events: 625 strokes, 469 MIs, and 364 cardiovascular deaths. Aspirin therapy was associated with a significant 12% reduction in cardiovascular events (odds ratio [OR], 0.88; 95% confidence interval [CI], 0.79-0.99; P = .03) and a 17% reduction in stroke (OR, 0.83; 95% CI, 0.70-0.97; P = .02), which was a reflection of reduced rates of ischemic stroke (OR, 0.76; 95% CI, 0.63-0.93; P = .008). There was no significant effect on MI or cardiovascular mortality. Among 44,114 men, there were 2047 major cardiovascular events: 597 strokes, 1023 MIs, and 776 cardiovascular deaths. Aspirin therapy was associated with a significant 14% reduction in cardiovascular events (OR, 0.86; 95% CI, 0.78-0.94; P = .01) and a 32% reduction in MI (OR, 0.68; 95% CI, 0.54-0.86; P = .001). There was no significant effect on stroke or cardiovascular mortality. Aspirin treatment increased the risk of bleeding in women (OR, 1.68; 95% CI, 1.13-2.52; P = .01) and in men (OR, 1.72; 95% CI, 1.35-2.20; P<.001). For women and men, aspirin therapy reduced the risk of a composite of cardiovascular events due to its effect on reducing the risk of ischemic stroke in women and MI in men. Aspirin significantly increased the risk of bleeding to a similar degree among women and men.

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Spontaneous unilateral adrenal hemorrhage: computerized tomography and magnetic resonance imaging findings in 8 cases.

C Hoeffel, P. Legmann, J P Luton … (1995)

We report and discuss the imaging features of 8 cases of spontaneous unilateral adrenal hematomas, a rare lesion. Computerized tomography (CT) was done in 8 cases, magnetic resonance imaging (MRI) in 5, and CT and MRI in 5. Imaging findings were reviewed and correlated with histological findings in all 8 cases. MRI was the most accurate imaging modality and showed variable appearances. On pathological evaluation the hematomas were old and organized. No contrast enhancement was noted on CT or MRI. One must not consider the diagnosis of spontaneous adrenal hematoma only as superimposed on a phechromocytoma or malignant lesion in the case of an incidentally discovered large adrenal mass with normal biological findings. MRI signs of adrenal hemorrhage and the failure of enhancement of such a mass should strongly suggest adrenal hematoma.

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Imaging of nontraumatic hemorrhage of the adrenal gland

A Kawashima, CM Sandler, RD Ernst … (1999)

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Author and article information

Contributors

Carmen Maciá Bobes: Role: ND

María Dolores Macías Robles: Role: ND

Aránzazu Ronzón Fernández: Role: ND

Patricia Botas Cervero: Role: ND

María del Valle López Díaz: Role: ND

Ana Isabel Municio Heras: Role: ND

Journal

Journal ID (publisher-id): urol

Title: Archivos Españoles de Urología (Ed. impresa)

Abbreviated Title: Arch. Esp. Urol.

Publisher: INIESTARES, S.A. (, , Spain )

ISSN (Print): 0004-0614

Publication date (Print and electronic): November 2007

Volume: 60

Issue: 9

Pages: 1119-1122

Affiliations

[02] Avilés orgnameHospital San Agustín orgdiv1Servicio de Urgencias

[04] Avilés orgnameHospital San Agustín orgdiv1Servicio de Radiodiagnóstico España

[01] Avilés orgnameHospital San Agustín orgdiv1Sección de Endocrinología

[03] Avilés orgnameCentro de Salud La Magdalena

Article

Publisher ID: S0004-06142007000900011

DOI: 10.4321/s0004-06142007000900011

SO-VID: c4a8b4fb-4bd4-4b09-b0bc-9111ca0018c1

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This work is licensed under a Creative Commons Attribution-NonCommercial 3.0 International License.

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SciELO Spain

Keywords: Glándulas suprarrenales,Hemorragia,Hipertensión arterial,Suprarrenalectomía,Feocromocitoma,Adrenal glands,Hemorrhage,Hypertension,Adrenalectomy,Pheochromocytoma

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Keywords: Glándulas suprarrenales, Hemorragia, Hipertensión arterial, Suprarrenalectomía, Feocromocitoma, Adrenal glands, Hemorrhage, Hypertension, Adrenalectomy, Pheochromocytoma

Hemorragia suprarrenal unilateral asociada a crisis hipertensiva en un paciente antiagregado Translated title: Unilateral adrenal hemorrhage and hypertensive crisis in a patient with antiplatelet treatment

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Most cited references 16

Aspirin for the primary prevention of cardiovascular events in women and men: a sex-specific meta-analysis of randomized controlled trials.

Spontaneous unilateral adrenal hemorrhage: computerized tomography and magnetic resonance imaging findings in 8 cases.

Imaging of nontraumatic hemorrhage of the adrenal gland

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