title: Primary antiphospholipid syndrome associated with acute adrenal failure.
abstract: We describe a 48-year-old woman with primary antiphospholipid syndrome who developed acute adrenal failure after an operation for a uterine myoma. After surgery, she developed a preshock state with hypotension, hypoglycemia, and hyponatremia. A diagnosis of primary antiphospholipid syndrome was made based not only on her past history of skin ulceration and recurrent spontaneous abortions but also on the presence of anticardiolipin antibodies. An abdominal computed tomography showed a bilateral enlargement of the adrenal glands but no high-density region in either gland. The patient recovered from the shock-like syndromes after the administration of glucocorticoids. Because it is possible that patients with antiphospholipid syndrome have acute or chronic adrenal failure caused by repeated hemorrhage or thrombosis, it may be important to monitor adrenal function in patients when the presence of this antibody is detected.
authors.affiliation: Department of Medicine, Koshigaya Hospital, Dokkyo University School of Medicine, Koshigaya, Japan. takeb@gmail.plala.or.jp
authors.forename: K
authors.initials: K
authors.lastname: Takebayashi
authors.forename: Y
authors.initials: Y
authors.lastname: Aso
authors.forename: K
authors.initials: K
authors.lastname: Tayama
authors.forename: Y
authors.initials: Y
authors.lastname: Takemura
authors.forename: T
authors.initials: T
authors.lastname: Inukai
mesh_terms: D000208:Acute Disease; D000307:Adrenal Gland Diseases / Q000175:diagnosis / Q000209:etiology*; D017153:Antibodies, Anticardiolipin / Q000097:blood; D016736:Antiphospholipid Syndrome / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D007003:Hypoglycemia; D007010:Hyponatremia; D007022:Hypotension; D007889:Leiomyoma / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications; D014057:Tomography, X-Ray Computed; D014594:Uterine Neoplasms / Q000601:surgery
chemical_list: D017153:Antibodies, Anticardiolipin; D005938:Glucocorticoids