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Article
May 9, 1953

SPONTANEOUS IDIOPATHIC BILATERAL ADRENAL APOPLEXY ASSOCIATED WITH HYPERTENSION

Author Affiliations

Johnstown, Pa.
From the laboratories of the Conemaugh Valley Memorial Hospital.

JAMA. 1953;152(2):133-134. doi:10.1001/jama.1953.63690020007004c
Abstract

Although bilateral adrenal hemorrhage has been commonly found at the postmortem examination of a person who died suddenly, it has been associated with meningococcemia or other sepsis,1 pregnancy,2 the neonatal state,3 heparin therapy,4 or leukemia.5 Standard textbooks refer only to these primary causes.6 Unilateral adrenal apoplexy complicating hypertension is also rare but several cases were reported in 1945 by Edelman.7 In 1947, McMillan8 presented the case of a 60-year-old-white man who was hospitalized because of severe epigastric pain and a blood pressure of 210/110 mm. Hg. The day after his admission, the patient's blood pressure suddenly fell to 96/50, with a weak and irregular pulse, and a high temperature developed. On the third day, the blood pressure dropped to 52/32, and the patient died. Autopsy revealed massive hemorrhage of both adrenal glands and a heart that weighed 500 gm. The arterioles of

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