Mohamed K.M. Shakir
Division of Endocrinology, Department of Medicine
Title: ADRENAL HEMORRAGE SECONDARY TO ANTIPHOSPHOLIPID SYNDROME CAUSING ADRENAL INSUFFICIENCY
Biography
Biography: Mohamed K.M. Shakir
Abstract
Objective: Antiphospholipid Syndrome (APS) can involve multiple organ systems but endocrine manifestations are rare. In most cases adrenal insufficiency (AI) is the first endocrine manifestation of APS. The prompt diagnosis of adrenal insufficiency is critical as adrenal insufficiency is a life-threatening disease that may lead to fatal outcomes if left untreated. We present a case of AI associated with antiphospholipid syndrome who was managed successfully.
Methods: A literature search was conducted using the databases PubMed and Google Scholar for diagnosis and management of adrenal insufficiency associated with antiphospholipid syndrome.
Results: We describe a 50-year-old male presenting with deep venous thrombosis and pulmonary embolism treated with heparin. The patient subsequently developed hypotension and worsening bilateral flank pain leading to a final diagnosis of adrenal hemorrhage during the course of his hospitalization. Adrenal insufficiency was diagnosed based on serum cortisol and ACTH levels.
Conclusions: In all cases of adrenal hemorrhage and infarction with unknown etiology, screening with lupus anticoagulant and anticardiolipin antibodies is imperative. Recognition of this high mortality condition will allow for appropriate screening and confirmatory tests leading to prompt diagnosis and timely management.