title: Autoimmune hemolytic anemia, primary adrenal insufficiency, and the antiphospholipid syndrome.
abstract: Autoimmune hemolytic anemia and adrenal insufficiency are rarely associated with the antiphospholipid antibody syndrome. A 49-year-old woman with a history of deep venous thrombosis and recurrent miscarriages was found to have active autoimmune hemolytic anemia after being admitted to the hospital for cholelithiasis. The patient was treated with corticosteroids and underwent laparoscopic cholecystectomy 1 month later. Two weeks after surgery she had acute adrenal insufficiency. Activated partial thromboplastin time was prolonged, and antiphospholipid antibodies were detected in significant titer. Her illness responded well to corticosteroid therapy. Her direct Coombs' test remained positive. It appears that the antiphospholipid antibody syndrome contributed to the development of venous thrombosis, recurrent miscarriages, autoimmune hemolytic anemia, adrenal insufficiency, and indirectly, pigment stone cholelithiasis in this patient.
authors.affiliation: Department of Medicine, Baylor College of Medicine, Houston, Texas, USA.
authors.forename: B
authors.initials: B
authors.lastname: Hsu
authors.forename: M M
authors.initials: MM
authors.lastname: Udden
authors.forename: E C
authors.initials: EC
authors.lastname: Lynch
mesh_terms: D000026:Abortion, Habitual / Q000276:immunology; D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000309:Adrenal Insufficiency / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D000744:Anemia, Hemolytic, Autoimmune / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D011247:Pregnancy; D013924:Thrombophlebitis / Q000276:immunology; D014057:Tomography, X-Ray Computed
chemical_list: D000305:Adrenal Cortex Hormones