Adrenal Insufficiency Complicated with Antiphospholipid Syndrome (APS)

• Fujishima Naohito

  Third Department of Internal Medicine, Akita University School of Medicine

• Komatsuda Atsushi

  Third Department of Internal Medicine, Akita University School of Medicine

• Ohyagi Hideaki

  Third Department of Internal Medicine, Akita University School of Medicine

• Fujishima Masumi

  Third Department of Internal Medicine, Akita University School of Medicine

• Tada Mitsunori

  Third Department of Internal Medicine, Akita University School of Medicine

• Ohtani Hiroshi

  Third Department of Internal Medicine, Akita University School of Medicine

• Wakui Hideki

  Third Department of Internal Medicine, Akita University School of Medicine

• Hirokawa Makoto

  Third Department of Internal Medicine, Akita University School of Medicine

• Sawada Ken-ichi

  Third Department of Internal Medicine, Akita University School of Medicine

Abstract

We describe a 69-year-old woman with bilateral adrenal hemorrhage complicated with antiphospholipid syndrome (APS). She was hospitalized with nausea and vomiting in September 2003. Laboratory data demonstrated hyponatremia, hypoglycemia and prolongation of activated partial thromboplastin time (aPTT). Abdominal computed tomography showed bilateral adrenal enlargement. In October 2003, she demonstrated altered mental status with progressive hyponatremia, a high level of ACTH, and a low level of serum cortisol. She also showed thrombocytopenia, anti-cardiolipin IgG antibody, anti-β2GPI antibody, and lupus anticoagulants. After four months, anti-cardiolipin IgG antibody was still positive. Based on these findings, she was diagnosed as having APS complicated with adrenal insufficiency due to hemorrhagic infarction. After treatment with corticosteroid, a low dose of aspirin and normal saline infusion, her condition quickly improved. Platelet counts and aPTT were also normalized. To our knowledge, this is the second Japanese case of APS complicated with bilateral adrenal hemorrhage. APS should be considered an important underlying cause of adrenal insufficiency.<br>

Journal

• Internal Medicine

  Internal Medicine 45 (16), 963-966, 2006

  The Japanese Society of Internal Medicine

Keywords

• adrenal hemorrhagic infarction
• adrenal insufficiency
• antiphospholipid syndrome

Details

• CRID: 1390282679847174272
• NII Article ID: 130000076462
• DOI: 10.2169/internalmedicine.45.1603
• ISSN: 13497235
• ISSN: 09182918
• Web Site: http://www.jstage.jst.go.jp/article/internalmedicine/45/16/45_16_963/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2007232707
• Text Lang: en
• Data Source:
  • JaLC
  • Crossref
  • CiNii Articles
• Abstract License Flag: Disallowed