Primary antiphospholipid syndrome presenting as hyponatremic hypertensive syndrome and acute adrenal insufficiency following it: a rare case

2009 ◽  
Vol 30 (2) ◽  
pp. 259-263 ◽  
Author(s):  
Neslihan Kurtulmus ◽  
Mehmet Ali Cikrikcioglu ◽  
Oyku Aksoy ◽  
Tufan Tukek
Keyword(s):  
Adrenal Insufficiency ◽  
Antiphospholipid Syndrome ◽  
Rare Case ◽  
Primary Antiphospholipid Syndrome ◽  
Acute Adrenal Insufficiency ◽  
Hyponatremic Hypertensive Syndrome

scholarly journals Acute adrenal failure as the heralding symptom of primary antiphospholipid syndrome: report of a case and review of the literature

2005 ◽  
Vol 153 (4) ◽  
pp. 507-514 ◽  
Author(s):  
Fabio Presotto ◽  
Francesca Fornasini ◽  
Corrado Betterle ◽  
Giovanni Federspil ◽  
Marco Rossato
Keyword(s):  
Abdominal Pain ◽  
Adrenal Insufficiency ◽  
Antiphospholipid Syndrome ◽  
Great Majority ◽  
Primary Antiphospholipid Syndrome ◽  
Adrenal Failure ◽  
Adrenal Haemorrhage ◽  
Morphological Findings ◽  
Acute Adrenal Insufficiency ◽  
Acute Adrenal Failure

Acute adrenal failure is a potentially fatal condition if overlooked. Occasionally, acute adrenal insufficiency may ensue from bilateral adrenal haemorrhage in patients with known antiphospholipid syndrome (APS). APS is characterized by recurrent arterial and venous thrombosis, pregnancy complications and detection of autoantibodies to phospholipids. This syndrome may be associated with non-organ specific diseases (e.g. connective tissue disorders) or with malignancies, but it may also appear in isolated form (primary APS). In a very few cases the heralding manifestation is given by adrenal failure. We report here a 63-year-old man presenting with acute adrenal insufficiency as the opening clinical manifestation of an APS. We also carried out a computer-aided search of the literature to identify all cases of primary adrenal failure as the first-recognized expression of a primary APS, a condition that not so infrequently may be tackled by endocrinologists. 20 patients fulfilled the inclusion criteria. The great majority of them were males (75%) with a mean age of 42 years. Abdominal pain was present in 14 patients, followed by fever (13 patients) and hypotension (12 patients). The main morphological findings by computed tomography or magnetic resonance were consistent with bilateral adrenal haemorrhage in 11 patients. Lupus anticoagulant was present in all of the 19 tested patients. Our observations emphasize the importance in the assessment of clotting times, and possibly of antiphospholipid antibodies, in all patients with diagnosis of rapidly progressive adrenal failure and concurrent abdominal pain.

scholarly journals Primary adrenal insufficiency due to bilateral adrenal infarction in COVID-19: a case report

2021 ◽  
Author(s):  
Iza F R Machado ◽  
Isabel Q Menezes ◽  
Sabrina R Figueiredo ◽  
Fernando Morbeck Almeida Coelho ◽  
Debora R B Terrabuio ◽  
...  
Keyword(s):  
Case Report ◽  
Adrenal Insufficiency ◽  
Antiphospholipid Syndrome ◽  
Antiphospholipid Antibodies ◽  
Case Reports ◽  
Serum Cortisol ◽  
Primary Adrenal Insufficiency ◽  
Acute Adrenal Insufficiency ◽  
Adrenal Infarction ◽  
New Onset

Abstract Context Coronavirus disease 2019 (COVID-19) is a proinflammatory and prothrombotic condition, but its impact on adrenal function has not been adequately evaluated. Case report A 46-year-old woman presented with abdominal pain, hypotension, skin hyperpigmentation after COVID-19 infection. The patient had hyponatremia, serum cortisol <1.0 ug/dL, ACTH of 807 pg/mL and aldosterone <3 ng/dL. Computed tomography (CT) findings of adrenal enlargement with no parenchymal and minimal peripheral capsular enhancement after contrast were consistent with bilateral adrenal infarction. The patient had autoimmune hepatitis and positive antiphospholipid antibodies, but no previous thrombotic events. The patient was treated with intravenous hydrocortisone, followed by oral hydrocortisone and fludrocortisone. Discussion Among 115 articles, we identified nine articles, including case reports, of new-onset adrenal insufficiency and/or adrenal hemorrhage/infarction on CT in COVID-19. Adrenal insufficiency was hormonally diagnosed in five cases, but ACTH levels were measured in only three cases (high in one case and normal/low in other two cases). Bilateral adrenal non- or hemorrhagic infarction was identified in five reports (two had adrenal insufficiency, two had normal cortisol levels and one case had no data). Interestingly, the only case with well-characterized new-onset acute primary adrenal insufficiency after COVID-19 had a previous diagnosis of antiphospholipid syndrome. In our case, antiphospholipid syndrome diagnosis was established only after the adrenal infarction triggered by COVID-19. Conclusions Our findings support the association between bilateral adrenal infarction and antiphospholipid syndrome triggered by COVID-19. Therefore, patients with positive antiphospholipid antibodies should be closely monitored for symptoms or signs of acute adrenal insufficiency during COVID-19.

scholarly journals ACUTE ADRENAL INSUFFICIENCY OF TUBERCULOSIS ORIGIN: CLINICAL CASE

2021 ◽  
Vol 9 (12) ◽  
pp. 588-592
Author(s):  
Fatima Akioud ◽  
◽  
Imane Moustaghit ◽  
Chaymaa Alami Hassani ◽  
Loubna Louday ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Rare Case ◽  
Clinical Case ◽  
Difficult Condition ◽  
Acute Adrenal Insufficiency

AdrenalTuberculosis is arare and difficult condition to diagnose. It issometimesdiscoveredduring the etiologicalassessment of adrenalinsufficiency. Hereafter, is a report of a rare case of adrenaltuberculosis revealed through acute adrenal insufficiency, associatedwithcutaneoustuberculosiswithout an active pulmonary component.

scholarly journals Definitive Adrenal Insufficiency Due to Bilateral Adrenal Hemorrhage and Primary Antiphospholipid Syndrome

1998 ◽  
Vol 83 (5) ◽  
pp. 1437-1439 ◽  
Author(s):  
Philippe Caron ◽  
Marie-Hélène Chabannier ◽  
Jean-Pierre Cambus ◽  
Françoise Fortenfant ◽  
Philippe Otal ◽  
...  
Keyword(s):  
Adrenal Insufficiency ◽  
Antiphospholipid Syndrome ◽  
Adrenal Hemorrhage ◽  
Primary Antiphospholipid Syndrome ◽  
Bilateral Adrenal Hemorrhage
Sign in / Sign up

Export Citation Format

Share Document