Bilateral thrombosis of the suprarenal veins as a cause of death is rare, and the clinical symptoms caused are so puzzling that the diagnosis is doubtful until a postmortem examination demonstrates the lesions. Sudden destruction of both suprarenal glands by extensive hemorrhages leads promptly to death,1 while a more chronic process, such as tuberculosis, brings about the changes of Addison's disease. Between these extremes are gradations of destruction and corresponding diminution of function which, according to statements recorded, may arouse a considerable variety of symptoms. These symptoms with acute injury of the suprarenal gland have been arranged by Lavenson2 and others in five groups: (1) a "peritoneal" form with epigastric pain, vomiting, at times diarrhea and profound prostration—symptoms resembling those in acute hemorrhagic pancreatitis; (2) an asthenic form ending fatally in a few days; (3) a nervous type with convulsions, delirium or coma; (4) a form with purpuric rash or
HIRSCH EF, CAPPS JA. PAROXYSMAL CYANOSIS: ASSOCIATED WITH BILATERAL THROMBOSIS OF THE SUPRARENAL VEINS. Arch Intern Med (Chic). 1927;40(1):112–119. doi:10.1001/archinte.1927.00130070115011
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