case report Open Access

Rare Presentation of Bilateral Adrenal Hemorrhage Following COVID-19 Vaccination: A Case Report and Literature Review

Thomas A. Baker, MD; Lisa M. Nguyen, MD; Richard H. Clark, MD, FACP

Department of Internal Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

Corresponding Author: Thomas A. Baker (tbaker@mgh.harvard.edu)

Received: December 1, 2024 Accepted: January 25, 2025 Published: February 1, 2025

DOI: 10.XXXXX/ajoams.2025.0103

Abstract

We present a rare case of bilateral adrenal hemorrhage in a 54-year-old male presenting with acute abdominal pain, hypotension, and fatigue three days following COVID-19 mRNA vaccination. Computed tomography revealed bilateral adrenal gland enlargement with hemorrhagic changes. Laboratory evaluation confirmed adrenal insufficiency with cortisol levels of 1.2 μg/dL. The patient was successfully managed with intravenous hydrocortisone and supportive care. This case highlights the importance of considering adrenal hemorrhage in the differential diagnosis of post-vaccination adverse events.

Keywords: adrenal hemorrhage COVID-19 vaccination adrenal insufficiency adverse events case report

📝 Cite This Article

Introduction

Bilateral adrenal hemorrhage is a rare but potentially life-threatening condition that can lead to acute adrenal insufficiency. We present a case that occurred following COVID-19 vaccination.

Case Presentation

A 54-year-old male with no significant past medical history presented to the emergency department with acute onset of bilateral flank and abdominal pain, associated with nausea, vomiting, and dizziness.

References

1. Rao RH, Vagnucci AH, Amico JA. Bilateral massive adrenal hemorrhage: early recognition and treatment. Ann Intern Med. 1989;110(3):227-235. 2. Simon DR, Palese MA. Clinical update on the management of adrenal hemorrhage. Curr Urol Rep. 2009;10(1):78-83.

How to Cite

APA Style

Thomas A. Baker, MD; Lisa M. Nguyen, MD; Richard H. Clark, MD, FACP (2025). Rare Presentation of Bilateral Adrenal Hemorrhage Following COVID-19 Vaccination: A Case Report and Literature Review. American Journal of Advanced Medical and Surgical Sciences, 2(1), 36-42. https://doi.org/10.XXXXX/ajoams.2025.0103

Vancouver Style

Thomas A. Baker, MD; Lisa M. Nguyen, MD; Richard H. Clark, MD, FACP. Rare Presentation of Bilateral Adrenal Hemorrhage Following COVID-19 Vaccination: A Case Report and Literature Review. Am J Adv Med Surg Sci. 2025;2(1):36-42. doi:10.XXXXX/ajoams.2025.0103

License: This article is published under the CC BY 4.0 license. Authors retain copyright while allowing anyone to read, download, and share the article, provided the original work is properly cited.