An Autopsy of Acute Adrenal Insufficiency Resulting from Infarction of Both Adrenal Glands, in a Pregnant Woman with Metastatic Carcinoma of the Breast

Journal of Clinical and Diagnostic Research

卷:15

Sharada Datar¹  Gwendolyn Fernandes² 

[1] Fellow, Department of Uropathology, G.S. Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India.;

[2] Professor Additional, Department of Pathology, G.S. Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India;

关键词: adrenal crisis;    adriamycin;    chemotherapy;    cyclophosphamide;    invasive breast carcinoma;   

DOI  :  10.7860/JCDR/2021/49231.15097

来源: DOAJ

【 摘 要 】

Acute Adrenal Insufficiency (AAI) is a life-threatening medical emergency, associated with high mortality, and requires early diagnosisand prompt management. This is an unusual case report of a 34-year-old female who was diagnosed with breast cancer, in the secondtrimester of pregnancy. She presented at 33 weeks gestation, in the emergency services, with convulsions, weakness, altered sensoriumand high-grade infiltrating duct carcinoma of breast with liver metastasis. She had also received a single cycle of chemotherapy withadriamycin and cyclophosphamide, at 33 weeks of pregnancy. Her condition deteriorated within 12-16 hours, and she developedabdominal pain, generalised weakness and convulsions. The patient was induced into labour, which was complicated, and delivered astill born male child. She also developed acute kidney injury and severe electrolyte imbalance, and died within four days of admission.A complete postmortem examination was performed where the cause of death was AAI following infarction of both adrenal glands in abackground of metastatic carcinoma of the breast. It is strongly suspected that chemotherapy with adriamycin and cyclophosphamideis the primary cause of AAI in the present case. However, the etiology could also be multifactorial as factors like, sepsis, intrauterinefoetal death and Disseminated Intravascular Coagulation (DIC) were also present.

【 授权许可】

Unknown