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Waterhouse-Friderichsen Syndrome & Addison´s Disease – Adrenal Insufficiency

by Carlo Raj, MD
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    Take a look at the picture here and we’re seeing Waterhouse-Friderichsen. That’s massive haemorrhage that’s taking place in the adrenals. What happened? That’s a fact that you had maybe an infection, meningococcemia Neisseria species or maybe perhaps DIC and DIC, what triggered this? All kinds of triggers, huh? Maybe it was acute myelogenous leukaemia type III, maybe this was a patient that had amniotic fluid emboli, maybe this was a patient that had severe sepsis. Whatever the case maybe, once DIC kicks in, oh my goodness, your patient looks like death. There is bleeding from every single orifice up and down his or her body and also internally. You have an increase in bleeding time PT and PTT, you have a decrease in platelet count and there might be massive haemorrhage into both of your adrenals resulting in primary adrenal insufficiency. Let’s take a look at the symptoms of both primary and secondary adrenal insufficiency. If you have complete destruction that’s taking place of your adrenal gland, then you can expect the following. You do not have cortisol, you do not have aldosterone and you might not be producing your adrenal androgens. If you don’t have aldosterone, you can expect your blood pressure to be extremely weak. If you don’t have aldosterone, you can expect to… you can expect the patient to not have much sodium. If you don’t have aldosterone, you can expect hyperkalemia and if you don’t have aldosterone, then you can expect your PH to be decreased, right? If you don’t have cortisol, adrenal insufficiency. Wow, you are worried about death. So, with all that said, weakness, weight loss, anorexia, nausea, vomiting, weakness especially maybe due to hypokalemia, there will be hypotension because there is no aldosterone, but that will be much more pronounced in primary. What’s...

    About the Lecture

    The lecture Waterhouse-Friderichsen Syndrome & Addison´s Disease – Adrenal Insufficiency by Carlo Raj, MD is from the course Adrenal Gland Disorders.


    Included Quiz Questions

    1. Meningococcemia
    2. Viremia
    3. Stapholococcus
    4. CMV
    5. Streptococcus
    1. Central obesity
    2. Hypotension
    3. Hyponatremia
    4. Weight loss
    5. Weakness
    1. Increased POMC leading to increased MSH
    2. Increased blood flow due to increased cortisol levels
    3. Increased POMC leading to increased ACTH
    4. Hypertension and cyanosis
    5. Increased ACTH leading to increased melanin deposition
    1. Hyperaldosteronism
    2. Low ACTH levels
    3. No hyperpigmentation of oral mucosa
    4. No hyperkalemia
    5. Disorder of hypothalamus and pituitary

    Author of lecture Waterhouse-Friderichsen Syndrome & Addison´s Disease – Adrenal Insufficiency

     Carlo Raj, MD

    Carlo Raj, MD


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