Primary Adrenal Failure due to Antiphospholipid Syndrome
Open accessAbstract
Background. Antiphospholipid syndrome (APS) characterized by thrombosis and abortus may rarely cause primary adrenal failure.Case Presentations. A 34-year-old male presented with hypotension, hypoglycemia, hyperpigmentation on his skin and oral mucosa, scars on both legs, and loss of consciousness. In laboratory examinations, hyponatremia (135 mmol/L), hyperpotassemia (6 mmol/L), and thrombocytopenia (83 K/µ L) were determined. Cortisol (1.91 µ g/dL) and adrenocorticotropic (550 pg/mL) hormone levels were also evaluated. The patient was hospitalized with a diagnosis of acute adrenal crisis due to primary adrenal insufficiency. A Doppler ultrasound revealed venous thrombosis. The patient was diagnosed with antiphospholipid syndrome after the detection of venous thrombosis, thrombocytopenia, elevated aPTT, and anticardiolipin antibody levels. Anticoagulation treatment was started for antiphospholipid syndrome. The patient is now following up with hydrocortisone, fludrocortisone, and warfarin sodium.Conclusion. Antiphospholipid syndrome is a rare reason for adrenal failure. Antiphospholipid syndrome should be suspected if patients have morbidity secondary to venous-arterial thrombosis.
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An adrenal crisis may occur in the setting of an acute insult to the adrenal or pituitary gland such as an infarction or haemorrhage.
“An adrenal crisis may occur in the setting of an acute insult to the adrenal or pituitary gland such as an infarction or haemorrhage.33–35”
From Adrenal crisis: prevention and management in adult patients (2019) · cites this paper as [34]
The Case section reports an acute adrenal crisis, and the Discussion says adrenal failure in antiphospholipid syndrome is probably related to hemorrhagic infarction or necrosis. The paper does not address pituitary infarction or hemorrhage as a cause of adrenal crisis, and it presents the adrenal mechanism as probable rather than demonstrated in this patient. Page numbers are not supplied in our copy. (LLM, conf=0.85)
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- [1]Miyakis S. Lockshin M. D. Atsumi T. International consensus statement on an update of the classification criteria for definite antiphospholipid syndrome (APS) Journal of Thrombosis and Haemostasis 2006 4 2 295 306 10.1111/j.1538-7836.2006.01753.x 2-s2.0-33344458573 16420554 · DOI · Paper page
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Adrenal crisis: prevention and management in adult patients
Dineen, R., Thompson, C. J., & Sherlock, M. (2019) · Therapeutic Advances in Endocrinology and Metabolism · doi:10.1177/2042018819848218 · Cited by 123 · see citing works
- Authors
- Sahin, M., Oguz, A., Tuzun, D., Boysan, S. N., Mese, B., Sahin, H., & Gul, K.
- Affiliations
- Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, 4600 Kahramanmaras, Turkey
- Clinic of Endocrinology and Metabolism, Necip Fazil State Hospital, 46050 Kahramanmaras, Turkey
- Department of Cardiovascular Surgery, Faculty of Medicine, Kahramanmaras Sutcu Imam University, 4600 Kahramanmaras, Turkey
- Clinic of Chest Diseases, Necip Fazil State Hospital, 46050 Kahramanmaras, Turkey
- Venue
- Case Reports in Endocrinology
- Publisher
- Hindawi Limited
- Published
- 2015
- Volume
- 2015
- Pages
- 1-3
- ISSN
- 2090-6501 (ISSN-L)
- 2090-651X
- PMC
- PMC4637077
- OpenAlex
- W2156066122
- Cited by
- 5
- References
- 0
- Citations by year
- 2025: 1 · 2023: 1 · 2020: 1 · 2019: 1 · 2017: 1
- FWCI
- 0.26
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Case Reports in Endocrinology (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Topics
- Health Sciences › Medicine › Rheumatology › Systemic Lupus Erythematosus Research
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
- Keywords
- antiphospholipid syndrome, Addison's disease, adrenal crisis, venous thrombosis, thrombocytopenia, hyponatremia, hyperkalemia, anticardiolipin antibodies, anticoagulation, cortisol, fludrocortisone, warfarin
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