{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T13:05:22Z","timestamp":1772802322624,"version":"3.50.1"},"reference-count":13,"publisher":"The Endocrine Society","issue":"12","license":[{"start":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T00:00:00Z","timestamp":1596240000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2020,12,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Context<\/jats:title>\n                  <jats:p>Bilateral adrenal hemorrhage is a rare condition with potentially life-threatening consequences such as acute adrenal insufficiency. Early adrenal axis testing, as well as directed imaging, is crucial for immediate diagnosis and treatment. Coronavirus disease 2019 (COVID-19) has been associated with coagulopathy and thromboembolic events.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Case description<\/jats:title>\n                  <jats:p>A 66-year-old woman presented with acute COVID-19 infection and primary adrenal insufficiency due to bilateral adrenal hemorrhage (BAH). She also had a renal vein thrombosis. Her past medical history revealed primary antiphospholipid syndrome (APLS). Four weeks after discharge she had no signs of COVID-19 infection and her polymerase chain reaction test for COVID-19 was negative, but she still needed glucocorticoid and mineralocorticoid replacement therapy. The combination of APLS and COVID-19 was probably responsible of the adrenal event as a \u201ctwo-hit\u201d mechanism.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>COVID-19 infection is associated with coagulopathy and thromboembolic events, including BAH. Adrenal insufficiency is life threatening; therefore, we suggest that early adrenal axis testing for COVID-19 patients with clinical suspicion of adrenal insufficiency should be carried out.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1210\/clinem\/dgaa487","type":"journal-article","created":{"date-parts":[[2020,8,1]],"date-time":"2020-08-01T12:17:14Z","timestamp":1596284234000},"page":"3745-3749","source":"Crossref","is-referenced-by-count":60,"title":["Bilateral Adrenal Hemorrhage in Coronavirus Disease 2019 Patient: A Case Report"],"prefix":"10.1210","volume":"105","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5094-7719","authenticated-orcid":false,"given":"Meir","family":"Frankel","sequence":"first","affiliation":[{"name":"Endocrinology Unit, Shaare Zedek Medical Center, Jerusalem, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Itamar","family":"Feldman","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Shaare Zedek Medical Center, Jerusalem, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michal","family":"Levine","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Shaare Zedek Medical Center, Jerusalem, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yigal","family":"Frank","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shaare Zedek Medical Center, Jerusalem, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Naama R","family":"Bogot","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shaare Zedek Medical Center, Jerusalem, Israel"},{"name":"Hadassah Hebrew University School of Medicine, Jerusalem, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ofer","family":"Benjaminov","sequence":"additional","affiliation":[{"name":"Department of Radiology, Shaare Zedek Medical Center, Jerusalem, Israel"},{"name":"Hadassah Hebrew University School of Medicine, Jerusalem, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ramzi","family":"Kurd","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Shaare Zedek Medical Center, Jerusalem, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel S","family":"Breuer","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Shaare Zedek Medical Center, Jerusalem, Israel"},{"name":"Department of Internal Medicine, Shaare Zedek Medical Center, Jerusalem, Israel"},{"name":"Hadassah Hebrew University School of Medicine, Jerusalem, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gabriel","family":"Munter","sequence":"additional","affiliation":[{"name":"Endocrinology Unit, Shaare Zedek Medical Center, Jerusalem, Israel"},{"name":"Department of Internal Medicine, Shaare Zedek Medical Center, Jerusalem, Israel"},{"name":"Hadassah Hebrew University School of Medicine, Jerusalem, Israel"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"80","published-online":{"date-parts":[[2020,8,1]]},"reference":[{"issue":"4","key":"2021122106251926400_CIT0001","doi-asserted-by":"crossref","first-page":"844","DOI":"10.1111\/jth.14768","article-title":"Abnormal coagulation parameters are associated with poor prognosis in patients with novel Coronavirus pneumonia","volume":"18","author":"Tang","year":"2020","journal-title":"J Thromb Haemost."},{"issue":"7","key":"2021122106251926400_CIT0002","doi-asserted-by":"crossref","first-page":"834","DOI":"10.1002\/ajh.25829","article-title":"Hematological findings and complications of COVID-19","volume":"95","author":"Terpos","year":"2020","journal-title":"Am J Hematol."},{"issue":"5","key":"2021122106251926400_CIT0003","doi-asserted-by":"crossref","first-page":"1094","DOI":"10.1111\/jth.14817","article-title":"Anticoagulant treatment is associated with decreased mortality in severe coronavirus disease 2019 patients with coagulopathy","volume":"18","author":"Tang","year":"2020","journal-title":"J Thromb Haemost."},{"issue":"5","key":"2021122106251926400_CIT0004","first-page":"411","article-title":"[A pathological report of three COVID-19 cases by minimal invasive autopsies]","volume":"49","author":"Yao","year":"2020","journal-title":"Zhonghua Bing Li Xue Za Zhi."},{"key":"2021122106251926400_CIT0005","doi-asserted-by":"crossref","first-page":"1076029620918308","DOI":"10.1177\/1076029620918308","article-title":"Hemorrhagic problem among the patients with COVID-19: clinical summary of 41 Thai infected patients","volume":"26","author":"Joob","year":"2020","journal-title":"Clin Appl Thromb Hemost."},{"issue":"6","key":"2021122106251926400_CIT0006","doi-asserted-by":"crossref","first-page":"997","DOI":"10.1136\/gutjnl-2020-321013","article-title":"Gastrointestinal symptoms of 95 cases with SARS-CoV-2 infection","volume":"69","author":"Lin","year":"2020","journal-title":"Gut."},{"issue":"3","key":"2021122106251926400_CIT0007","doi-asserted-by":"crossref","first-page":"229","DOI":"10.1007\/s10140-020-01775-4","article-title":"Three unsuspected CT diagnoses of COVID-19","volume":"27","author":"Vu","year":"2020","journal-title":"Emerg Radiol."},{"issue":"3","key":"2021122106251926400_CIT0008","doi-asserted-by":"crossref","first-page":"211","DOI":"10.1097\/00005792-197805000-00002","article-title":"Adrenal hemorrhage in the adult","volume":"57","author":"Xarli","year":"1978","journal-title":"Medicine (Baltimore)"},{"issue":"2","key":"2021122106251926400_CIT0009","doi-asserted-by":"crossref","first-page":"163","DOI":"10.1542\/peds.40.2.163","article-title":"Study of adrenal function in children with meningitis","volume":"40","author":"Migeon","year":"1967","journal-title":"Pediatrics"},{"issue":"2","key":"2021122106251926400_CIT0010","doi-asserted-by":"crossref","first-page":"109","DOI":"10.1016\/S0049-0172(95)80024-7","article-title":"Adrenal insufficiency in the antiphospholipid antibody syndrome","volume":"25","author":"Arnason","year":"1995","journal-title":"Semin Arthritis Rheum."},{"issue":"8","key":"2021122106251926400_CIT0011","doi-asserted-by":"crossref","first-page":"3179","DOI":"10.1210\/jc.2012-4300","article-title":"Primary adrenal insufficiency due to bilateral adrenal hemorrhage-adrenal infarction in the antiphospholipid syndrome: long-term outcome of 16 patients","volume":"98","author":"Ramon","year":"2013","journal-title":"J Clin Endocrinol Metab."},{"issue":"1","key":"2021122106251926400_CIT0012","doi-asserted-by":"crossref","first-page":"123","DOI":"10.1046\/j.1365-2265.2000.00903.x","article-title":"Adrenal insufficiency as the first clinical manifestation of the primary antiphospholipid antibody syndrome","volume":"52","author":"Satta","year":"2000","journal-title":"Clin Endocrinol (Oxf)."},{"issue":"17","key":"2021122106251926400_CIT0013","doi-asserted-by":"crossref","first-page":"e38","DOI":"10.1056\/NEJMc2007575","article-title":"Coagulopathy and antiphospholipid antibodies in patients with Covid-19","volume":"382","author":"Zhang","year":"2020","journal-title":"N Engl J Med."}],"container-title":["The Journal of Clinical Endocrinology &amp; Metabolism"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/academic.oup.com\/jcem\/advance-article-pdf\/doi\/10.1210\/clinem\/dgaa487\/33557345\/dgaa487.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/105\/12\/3745\/41829279\/dgaa487.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jcem\/article-pdf\/105\/12\/3745\/41829279\/dgaa487.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,12,21]],"date-time":"2021-12-21T06:25:54Z","timestamp":1640067954000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jcem\/article\/105\/12\/3745\/5879684"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,1]]},"references-count":13,"journal-issue":{"issue":"12","published-online":{"date-parts":[[2020,8,1]]},"published-print":{"date-parts":[[2020,12,1]]}},"URL":"https:\/\/doi.org\/10.1210\/clinem\/dgaa487","relation":{},"ISSN":["0021-972X","1945-7197"],"issn-type":[{"value":"0021-972X","type":"print"},{"value":"1945-7197","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2020,12]]},"published":{"date-parts":[[2020,8,1]]}}}