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Annals of Hematology

, Volume 98, Issue 10, pp 2421–2423 | Cite as

Acute myeloid leukemia presenting as bilateral adrenal hemorrhage

  • Hadrian MendozaEmail author
  • Nikolai A. Podoltsev
  • Alexa J. Siddon
  • Karthik Gnanapandithan
Letter to the Editor
  • 62 Downloads

Dear Editor,

Bilateral adrenal hemorrhage is a rare medical emergency that can result in hypotensive shock and death without prompt treatment [1]. Acute myeloid leukemia (AML) is the most common acute leukemia in adults [2] and is defined by the presence of 20% or more myeloblasts in the marrow or blood [3]. We report here a patient whose initial diagnosis of AML was made following presentation with bilateral adrenal hemorrhage initially without evidence for adrenal insufficiency but later complicated with adrenal crisis.

A 71-year-old female with no significant medical history presented to the emergency department with increasing abdominal pain for 2 days. Her hemoglobin was 9.1 g/dl, platelets were 73 × 10 9/L, and total leukocyte count was 15.2 × 10 9/L with 4% blasts in peripheral blood smear. CT imaging (Fig.  1a, b) and MRI (Fig. 1c, d) of the abdomen revealed bilateral adrenal hemorrhage. There were no clinical features of adrenal insufficiency on presentation; cortisol was...

Notes

Compliance with ethical standards

Conflict of interest

NAP consulted for and received honoraria from Alexion, Pfizer, Agios Pharmaceuticals, Blueprint Medicines, Incyte, Novartis; received research funding (all to the institution) from Boehringer Ingelheim, Astellas Pharma, Daiichi Sankyo, Sunesis Pharmaceuticals, Jazz Pharmaceuticals, Pfizer, Astex Pharmaceuticals, CTI BioPharma, Celgene, Genentech, AI Therapeutics, Samus Therapeutics, Arog Pharmaceuticals, Kartos Therapeutics; and received grant funding from Celgene. Other authors (HM, AJS, and KG) report no relevant financial conflicts of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent

Informed consent was obtained from the individual included in this report.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Laboratory MedicineYale School of MedicineNew HavenUSA
  2. 2.Department of PathologyYale School of MedicineNew HavenUSA
  3. 3.Hematology Section, Department of Internal MedicineYale School of MedicineNew HavenUSA
  4. 4.Department of Internal MedicineYale School of MedicineNew HavenUSA

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