Adrenal insufficiency after laparoscopic hysterectomy in a patient with primary antiphospholipid syndrome.
BACKGROUND
We report a case of bilateral adrenal hemorrhage and subsequent adrenal insufficiency after a laparoscopic hysterectomy in a patient with anticardiolipin antibody syndrome.


METHODS
A 55-year-old woman with a history of anticardiolipin antibody syndrome presented with nausea and vomiting 1 week after laparoscopic hysterectomy and staging for endometrial adenocarcinoma. Based on a diagnosis of adrenal insufficiency, the patient was started on oral hydrocortisone 20 mg in the morning and 10 mg in the afternoon, and fludrocortisone 0.05 mg twice daily on day 5. Her symptoms resolved completely within 24 hours of beginning steroids.


CONCLUSIONS
The diagnosis of adrenal insufficiency should be entertained in any patient with a history of thrombophilias presenting with general abdominal complaints.
Dierking
E
E
Department of Obstetrics and Gynecology, New York University, New York, New York 10016, USA.
Gogoi
R
R
Adamcik
S
S
Greene
L W
LW
Curtin
J P
JP
D000230:Adenocarcinoma / Q000150:complications / Q000601:surgery; D000309:Adrenal Insufficiency / Q000175:diagnosis / Q000209:etiology*; D016736:Antiphospholipid Syndrome / Q000150:complications / Q000601:surgery*; D016889:Endometrial Neoplasms / Q000150:complications / Q000601:surgery; D005260:Female; D006801:Humans; D007044:Hysterectomy / Q000009:adverse effects*; D010535:Laparoscopy; D008875:Middle Aged