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Issue 147 Spring 2023

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Clinical members of the Society for Endocrinology may recall receiving a survey last year about their experience of patients with COVID-19-related adrenal haemorrhage (AH). The Society’s task force that is charged with describing the UK experience of this condition has now collated and reported these data, along with a systematic literature review.

Elhassan et al. provide a detailed descriptive summary of the presentations and outcomes of 18 UK patients with either COVID-19 infection-related AH (n=7) or COVID-19 vaccination-related AH (n=11) (the latter being defined by COVID-19 vaccination 5–30 days prior to detection of the adrenal problem). It is of note that most of these patients had a concomitant diagnosis of definite or probable vaccine-induced immune thrombocytopenia and thrombosis (VITT).

AH is thought to be an under-diagnosed condition. This study will therefore make useful reading for both acute physicians and endocrinologists. In particular, the authors highlight acute abdominal pain as a presenting feature, and thus the need to consider this diagnosis in patients with COVID-19 infection, or with COVID-19 VITT, who report abdominal pain.

AH was bilateral in 12 out of 18 patients, and all of these patients required glucocorticoid treatment. The authors therefore suggest immediate, empirical glucocorticoid replacement in bilateral AH, with a low threshold for its initiation in patients with unilateral AH, especially when VITT is present.

Read the full article in Clinical Endocrinology doi:10.1111/cen.14881

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