Nadira Mamoon, Nadira Mamoon, Manzoor Ahmed, Amir Hussain Khan, Azhar Mubarik, Iftikhar Ahmad Malik.
Massive Adrenal Haemorrhage with sudden death in young Adults.
Pak Armed Forces Med J Jan ;48(1):4-6.

31 cases of massive adrenal haemorrhage causing sudden death are described. All the subjects were young adults in military service. Twenty seven (87.1%) were recruits undergoing rigorous military training. The majority (96%) had a very short duration of preceding symptoms and 6 of them suffered sudden collapse. Apart from adrenal haemorrhage, the only other significant post-mortem finding was meningeal infiltration by neutroplihs in 8 cases (25.8%). Meningococcal septicaemia is the most commonly associated condition with adrenal haemorrhage in the Waterhaus Freiderichsen syndrome. Meningococcal infection is also a prevalent disorder in this population. These cases may represent a modified form of menigococcal infection, causing fatal haemorrhages in the over stressed adrenals, before the classical features of septicaemia can appear.

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