BILATERAL MASSIVE ADRENAL HEMORRHAGE

Bilateral hemorrhage into the adrenal glands is a potentially lethal c ondition that must be recognized and treated immediately if the patien t is to survive. Recognition is hampered by the fact that clinical sig ns are vague and laboratory abnormalities are not diagnostic. A high i ndex of suspicion maintained in a patient with the appropriate risk pr ofile, and aggressive treatment with steroids as soon as the diagnosis is suspected, will ensure survival. Subsequent hormonal and anatomic confirmation should be followed by life-long steroid therapy, since co mplete adrenal destruction is the norm.