Systemic lupus erythematosus with adrenal insufficiency

Eichner, H; Schambelan, Morris; Biglieri, Edward G.

doi:10.1016/0002-9343(73)90194-0

Cited by 19 publications

(7 citation statements)

References 18 publications

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“…Overt Addi-son's disease is reported to occur in 0.4% of patients with definite APS. 5 Reports of an association between aPL antibodies and hypoadrenalism go back to 1973 when Eichner et al 6 reported a 26-year-old woman newly diagnosed with systemic lupus erythematosus (SLE) who suffered AI. She had a false-positive syphilis test and a prolonged partial thromboplastin time, suggesting the presence of an ''anticoagulant'' in her circulation.…”

Section: Adrenal Glandmentioning

confidence: 99%

Antiphospholipid Syndrome: Endocrinologic Manifestations and Organ Involvement

Mehdi

Salti

Uthman

2011

Semin Thromb Hemost

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Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thrombotic tendency that affects most organ systems in the human body. In this report, we present a review of the endocrinologic manifestations associated with APS by evaluating the medical literature from 1968 to 2009 using MEDLINE and these keywords: APS, antiphospholipid syndrome, antiphospholipid antibodies, anticardiolipin antibodies, lupus anticoagulant, anti β-2 glycoprotein I, pituitary, adrenal, thyroid, parathyroid, ovary, testes, diabetes mellitus, and diabetes insipidus. Adrenal insufficiency was found to be the most common endocrine manifestation associated with APS. Autoimmune thyroid disease was associated with increased titers of antiphospholipid antibodies (aPL) without any APS clinical manifestations. In addition, hypopituitarism and Sheehan syndrome are increasingly being reported in association with aPL. Data regarding the prevalence and significance of aPL in diabetic patients remains uncertain. Finally, only a few cases of ovarian and testicular derangements have been reported. APS should be considered in any patient with adrenal insufficiency even in the absence of other thrombotic manifestations. It is also advisable to assess aPL in the sera of patients presenting with pituitary insufficiency. Further studies are needed to clarify the relationship between aPL and thyroid disorders and diabetes mellitus.

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Section: Adrenal Glandmentioning

confidence: 99%

Antiphospholipid Syndrome: Endocrinologic Manifestations and Organ Involvement

Mehdi

Salti

Uthman

2011

Semin Thromb Hemost

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“…[78] The possible explanation for this association could be explained by a common autoimmune process, which is found in both clinical conditions. Alternatively, adrenal insufficiency could result from vasculitis induced by SLE per se .…”

Section: Discussionmentioning

confidence: 99%

Systemic lupus erythematosus presenting as acute adrenal insufficiency: A rare clinical presentation

Bhat

Khan

et al. 2014

Ann Med Health Sci Res

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Systemic lupus erythematosus is a complex autoimmune disease with multisystem involvement with varied presentation. Autoimmune adrenal disease, on the other hand, can be associated with other autoimmune diseases. Adrenal insufficiency as a presenting feature of Systemic lupus erythematosus is a rare occurrence. We hereby report a case of a 20 year-old female who presented to us in an acute hypoadrenal state and was found to have Systemic lupus erythematosus with renal involvement. Patient was successfully managed with steroids and improved clinically.

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“…The clinical relationship of amyloidosis to the present patient's adrenal insufficiency was not appreciated because there was no significant renal disease, as one would expect with amyloidosis. The occurrence of systemic lupus erythematosus with adrenal insufficiency has been reported recently and the literature has been reviewed, but no conclusive etiologic explanation for this coexistence was found and amyloidosis as a causative factor was not considered (4).…”

Section: Discussionmentioning

confidence: 99%

Lupus erythematosus in a patient with amyloidosis, adrenal insufficiency, and subsequent immunoblastic sarcoma. Demonstration of the le phenomenon in the lung

Schleissner

Sheehan

Orselli

1976

Arthritis & Rheumatism

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A patient with systemic lupus erythematosus of long duration developed secondary amyloidosis and finally died after the additional complication of malignant lymphoproliferative disease. Multiple system involvement, typical serologic findings, and postmortem evidence substantiated the diagnosis of lupus erythematosus. Amyloid deposition was found in several organs, but was notably extensive in the adrenal cortex. This extensive deposition resulted in adrenal insufficiency, which was diagnosed clinically and treated until the patient's death from lymphoma. The particular nature of the malignant lymphoma is emphasized; a distinctive feature was the disappearance of positive lupus erythematosus cells from the buffy coat and the reduction in titers of relevant serologic tests toward the end of the illness. In spite of this reduction, many hematoxylin bodies and abundant complete lupus er- T h i s report describes a patient with long-standing systemic lupus erythematosus w h o developed adrenal insufficiency secondary t o amyloidosis. Several m o n t h s later t h e patient developed a n d died from complications of a n unusual malignant lymphoma. Postmortem examination demonstrated the presence of hematoxylin bodies and LE cells in t h e lungs. CASE REPORTThe patient was a 65-year-old Mexican male, admitted to the hospital for nausea, abdominal pain, weakness, and dizziness on February 8, 1970. The patient also complained of pain, stiffness, and swelling of his wrists, elbows, shoulders, and ankles. His history revealed periodic exacerbations and remissions also involving the metatarsal phalangeal joints and metacarpal phalangeal joints, neck stiffness, and pain and stiffness in the sacrolumbar region since 1962. In 1960 he was comatose for several days, but no specific diagnosis was made. There was no history of ingestion of procainamide, hydralazine, isoniazid, dilantin, phenothiazines, or other drugs that could be associated with the development of a lupus-like illness.Physical examination on admission in 1970 revealed a supine blood pressure of 120/60 mm Hg, pulse 72 and regular. On standing, the blood pressure dropped to 80/60 mm Hg and the pulse rose to 100. There was patchy scalp alopecia. The skin areas behind his ears, neck, and the creases of his arms and hands were hyperpigmented. Gynecomastia was noted.

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Systemic lupus erythematosus with adrenal insufficiency

Cited by 19 publications

References 18 publications

Antiphospholipid Syndrome: Endocrinologic Manifestations and Organ Involvement

Antiphospholipid Syndrome: Endocrinologic Manifestations and Organ Involvement

Systemic lupus erythematosus presenting as acute adrenal insufficiency: A rare clinical presentation

Lupus erythematosus in a patient with amyloidosis, adrenal insufficiency, and subsequent immunoblastic sarcoma. Demonstration of the le phenomenon in the lung

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