Acute secondary adrenal insufficiency due to spontaneous adrenal hemorrhage in antiphospholipid syndrome: a case series
Keywords:
Addison disease, corticoadrenal insufficiency, antiphospholipidic syndrome
Abstract
In adrenal insufficiency (AI), the progressive destruction of adrenal tissue leads to a decrease in the secretion of adrenal corticoids, such that once established, the clinical picture becomes severe, and without treatment, there is a high mortality rate. Antiphospholipid syndrome (APS) is a rare cause of AI. Given this and the scarcity of available literature, two cases of AI due to APS are presented in a private clinic in the city of Santa Fe, Argentina. Both cases were characterized by being female, having a previous diagnosis of APS, and not having other sites of thrombosis at the time of consultation. The manifestation as adrenal hemorrhage and the fact of being previously on anticoagulant therapy posed a diagnostic challenge. Although AI is an uncommon condition, and even more so when linked to APS, the severity of the pathology, as well as the rapidity of its onset, warrant a high clinical suspicion when the syndromic picture is suggestive.References
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III. Böber E, Kovanlikaya A, Büyükgebiz A. Primary antiphospholipid syndrome: an unusual cause of adrenal insufficiency. Horm Res 2001;56(3-4):140-4.
IV. Díaz-Coronado JC, Herrera-Uribe S, Hernández-Parra D, Betancur-Vásquez L, Lacouture-Fierro J, González-Hurtado D, et al. Síndrome antifosfolípido (SAF): diferencias clínicas e inmunoserológicas entre SAF primario y secundario en una cohorte colombiana. Rev Colomb Reumatol 2021;28(3):191-6.
V. Candel-González FJ, Matesanz-David M, Candel-Monserrate I. Insuficiencia corticosuprarrenal primaria: enfermedad de Addison. An Med Int 2001;18(9):48-54.
VI. Presotto F, Fornasini F, Betterle C, Federspil G, Rossato M. Acute adrenal failure as the heralding symptom of primary antiphospholipid syndrome: report of a case and review of the literature. Eur J Endocrinol 2005;153(4):507-14.
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VIII. Carette S, Jobin F. Acute adrenal insufficiency as a manifestation of the anticardiolipin syndrome? Ann Rheum Dis 1989;48(5):430-1.
IX. Barreiro-García G, Egurbide-Arberas MV, Álvarez-Blanco A, Ugalde-Espiñeira J, Aguirre-Errasti C. Insuficiencia suprarrenal aguda por hemorragia suprarrenal bilateral como primera manifestación de un síndrome antifosfolípido: a propósito de un caso y revisión. An Med Int 2002;19(1):19-22.
Published
2023-12-30
How to Cite
1.
Benzaquén N, Riera J, Giménez S, Castro M. Acute secondary adrenal insufficiency due to spontaneous adrenal hemorrhage in antiphospholipid syndrome: a case series. Rev. Argent. Reumatol. [Internet]. 2023Dec.30 [cited 2024May14];34(4):131 -134. Available from: https://ojs.reumatologia.org.ar/index.php/revistaSAR/article/view/789
Section
Clinical Case
Copyright (c) 2023 on behalf of the authors. Reproduction rights: Argentine Society of Rheumatology
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