Bilateral Adrenal Hemorrhage and Adrenal Insufficiency in the Context of Polycythemia Vera: A Case Report and Review of the Literature
Table 1
Laboratory results of the admitted patient.
Laboratory data
First result
Second result
Reference ranges
White blood cells (103/l)
28.5
24.2
4–11
PMN (%)
92
93
45–77
Lymph (%)
5
5
14–44
Mix (%)
3
2
4–20
Hemoglobin (g/dl)
15.5
15.6
14–17.5
Hematocrit
50%
50%
41.5–50.5
MCV (fL)
83.1
83
80–96
MCH (pg)
25.5
25.5
27–33
MCHC (g/dL)
30.7
30.7
31.5–35
Platelets (106/l)
313
198
150–400
PTT (sec)
49
48
25–36
PT (sec)
14
—
10–13
INR
1.1
1.29
1–1.2
Blood urea nitrogen (mg/dl)
13.2
40
8.4–27.5
Creatinine (mg/dl)
1.07
4
0.86–1.4
Sodium (mEq/l)
138
138
135–145
Potassium (mEq/l)
3.8
4.9
3.6–5.2
Blood sugar (mg/dl)
206
74
60–99
Amylase (U/l)
59
33
10–100
Lipase (U/l)
13.8
14
<60
Aspartate aminotransferase (U/l)
16
20
10–40
Alanine aminotransferase (U/l)
16
16
10–41
Alkaline phosphatase (U/l)
309
221
80–306
Total bilirubin (mg/dl)
0.8
0.8
0.1–1.1
Direct bilirubin (mg/dl)
0.47
0.3
0.1–0.3
LDH (U/l)
625
680
140–500
Troponin I (ng/l)
Negative
147.2
<0.1
Calcium (mg/dl)
—
8.5
8.6–10.3
Phosphorus (mg/dl)
—
5
2.8–4.5
Albumin (g/dl)
—
3.5
3.4–5.2
Magnesium (mg/dl)
—
2.1
1.3–2.1
CPK (U/l)
—
86
30–200
ESR (mm)
—
3
Male: 0–22 Female: 0–29
CRP (mg/dl)
—
75
0–6
Uric acid (mg/dl)
—
12.4
3.5–7.2
Venous blood gas
PH
—
7.30
7.33–7.43
PCO2
—
32
41–51
HCO3
—
17
24–28
Urine analysis
Specific gravity
—
1025
Protein
—
+
Red blood cell
—
Many
White blood cell
—
6–8
Bacteria
—
Few
Fluid cultures
Urine culture
—
Negative
Blood culture (two times)
—
Negative
The reticulocyte count and peripheral blood smear were not assessed. PMN: polymorphonuclear, MCV: mean corpuscular volume, MCH: mean corpuscular hemoglobin, MCHC: mean corpuscular hemoglobin concentration, PTT: partial thromboplastin time, PT: prothrombin time, INR: international randomized ratio, LDH: lactate dehydrogenase, CPK: creatine phosphokinase, ESR: erythrocyte sedimentation rate, and CRP: C-reactive protein.
