Adrenal crisis due to bilateral adrenal hemorrhage in primary antiphospholipid syndrome.
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2005-04-09
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Abstract
The authors report a case of a 56-year-old Thai woman with a history of recurrent venous thrombosis, spontaneous abortion and Graves' disease who presented with bilateral flank pain, nausea, vomiting and low-grade fever followed by hypotension. Adrenal crisis from bilateral adrenal hemorrhage was diagnosed by a low serum cortisol level during hypotension and bilateral hyperdense oval masses in each of the adrenal glands in a computerized tomographic study. Her hemostatic and serologic profile was compatible with primary antiphospholipid syndrome. Rapid improvement was observed after the administration of intravenous hydrocortisone. She was discharged on long-term glucocorticoid replacement for her primary adrenal insufficiency as well as an anticoagulant for prevention of thrombosis. The antiphospholipid syndrome should be suspected in a patient presenting with adrenal crisis without a distinct etiology.
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Chotmaihet Thangphaet.
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Ringkananon U, Khovidhunkit W, Vongthavaravat V, Sridama V, Lalitanantpong S, Snabboon T. Adrenal crisis due to bilateral adrenal hemorrhage in primary antiphospholipid syndrome. Journal of the Medical Association of Thailand. 2005 Apr; 88(4): 534-7