Adrenal involvement in the antiphospholipid syndrome

Espinosa, Gerard; Cervera, Ricard; Font, Josep; Asherson, Ronald A.

doi:10.1191/0961203303lu404oa

Cited by 43 publications

(36 citation statements)

References 10 publications

(9 reference statements)

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“…Acute adrenal failure may be the first clinical manifestation of APS, whereas a few patients may have a history of Addison's disease. Adrenal failure is present in 10%-26% of patients with catastrophic APS [51]. The pathophysiologic mechanism is not clearly understood, but an adrenal vein thrombosis could provoke an adrenal haemorrhagic infarction [51].…”

Section: Hypocortisolismmentioning

confidence: 99%

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The coagulation system in endocrine disorders: A narrative review

et al. 2007

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Endocrine disorders can influence the haemostatic balance. Abnormal coagulation test results have been observed in patients with abnormal hormone levels. Also unprovoked bleeding or thrombotic events have been associated with endocrine disease. The aim of the present review is to summarise the available evidence on the influence of common endocrine disorders on the coagulation system, and their possible clinical implications. We focus on thyroid dysfunction, hyper- and hypocortisolism and growth hormone disturbances, while other endocrine disorders are only briefly discussed. In the published literature a clear bleeding diathesis has only been associated with overt hypothyroidism, mainly mediated by an acquired von Willebrand syndrome. A clinically relevant hypercoagulable state may be present in patients with hyperthyroidism, hypercortisolism or abnormal growth hormone levels, but adequate prospective clinical studies are lacking. Also effects of pheochromocytoma, hyperprolactinaemia and hyperaldosteronism on the coagulation system have been described. It is apparent that unprovoked bleeding and thrombotic episodes can be secondary to endocrine disorders.

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Section: Hypocortisolismmentioning

confidence: 99%

“…Adrenal failure is present in 10%-26% of patients with catastrophic APS [51]. The pathophysiologic mechanism is not clearly understood, but an adrenal vein thrombosis could provoke an adrenal haemorrhagic infarction [51]. APS should be considered as a possible cause of Addison's disease when the aetiology is unclear.…”

Section: Hypocortisolismmentioning

confidence: 99%

The coagulation system in endocrine disorders: A narrative review

et al. 2007

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“…En 2003, Espinosa et al analizaron 86 casos, en los cuales se estableció la relación entre el síndrome antifosfolípido y la insuficiencia suprarrenal. En esta serie, en más de un tercio de los pacientes, la primera manifestación del síndrome antifosfolípido fue la insuficiencia suprarrenal [8]. La mayoría de los casos reportados correspondía al síndrome de Asherson, en el que había compromiso de múltiples órganos, como en el caso 2 reportado por nosotros.…”

Section: Discussionunclassified

Síndrome antifosfolípido y necrosis suprarrenal, reporte de dos casos y revisión de la literatura científica

2011

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ResumenEl síndrome antifosfolípido es una entidad que puede ocurrir de forma aislada o asociada a otras enfermedades. Una forma infrecuente es la manifestación con compromiso de las glándulas suprarrenales. Existen pocos casos en la literatura científica que describan este fenómeno. En el presente artículo, se presentan dos casos con comportamientos poco usuales.Palabras clave: síndrome antifosfolípido, enfermedad de Addison, necrosis. TitleAntiphospholipid syndrome and adrenal gland necrosis, report of two cases and review of the literature AbstractAntiphospholipid syndrome is a disease that can manifest alone or associated with other conditions. Adrenal glands involvement is a rare presentation. There are few cases reported in the literature. We present two cases of patients with antiphospholipid syndrome that compromise the adrenal glands and behave very odd comparing to previous case reports.

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“…Adrenal insufficiency is a recognized consequence of antiphospholipid antibody syndrome (13), and it may be due to adrenal vein thrombosis, resulting in parenchymal hemorrhage because of the profuse small venous channels found throughout the adrenal gland (14). The MR findings of adrenal hemorrhage vary according to the time course of hematoma formation (15).…”

Section: Discussionmentioning

confidence: 99%

Case 81: Antiphospholipid Antibody Syndrome with Adrenal Hemorrhage and Budd-Chiari Syndrome

Bhattacharya¹,

Yeh²,

Qayyum³

et al. 2005

Radiology

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A 56-year-old man with end-stage liver disease presented to the emergency department with increasing fatigue and an unexplained weight loss of 16 kg over the preceding 3 months. His past medical history included multiple episodes of abdominal pain and ascites for 30 years. He did not consume alcohol. Physical examination demonstrated a blood pressure of 70/50 mm Hg but was otherwise unremarkable. Laboratory studies demonstrated a sodium level of 131 mEq/L (131 mmol/L) (normal range, 135-145 mEq/L [135-145 mmol/L]), potassium level of 5.5 mEq/L (5.5 mmol/L) (normal range, 3.5-5.0 mEq/L [3.5-5.0 mmol/L]), platelet count of 52 ϫ 10 9 /L (normal range, 140 -450 ϫ 10 9 /L), and partial thromboplastin time of more than 100 seconds (normal range, 24.5-35.2 seconds). The results of serology were negative for viral hepatitis. Abdominal magnetic resonance (MR) imaging was performed. IMAGING FINDINGSBoth the transverse and coronal MR images (Figs 1 and 2) demonstrate inhomogeneity of the hepatic parenchyma with an irregular hepatic contour. Transverse MR images (Fig 1) demonstrate a right adrenal mass with central low T1 signal intensity, peripheral high T1 signal intensity, diffuse high T2 signal intensity, and lack of enhancement after administration of intravenous gadolinium-based contrast material. Coronal MR images (Fig 2) demonstrate enlarged collateral vein, marked narrowing of the intrahepatic inferior vena cava, and splenomegaly.

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Adrenal involvement in the antiphospholipid syndrome

Cited by 43 publications

References 10 publications

The coagulation system in endocrine disorders: A narrative review

The coagulation system in endocrine disorders: A narrative review

Síndrome antifosfolípido y necrosis suprarrenal, reporte de dos casos y revisión de la literatura científica

Case 81: Antiphospholipid Antibody Syndrome with Adrenal Hemorrhage and Budd-Chiari Syndrome

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