title: Primary Adrenal Failure due to Antiphospholipid Syndrome.
abstract: Background. Antiphospholipid syndrome (APS) characterized by thrombosis and abortus may rarely cause primary adrenal failure. Case Presentations. A 34-year-old male presented with hypotension, hypoglycemia, hyperpigmentation on his skin and oral mucosa, scars on both legs, and loss of consciousness. In laboratory examinations, hyponatremia (135 mmol/L), hyperpotassemia (6 mmol/L), and thrombocytopenia (83 K/µL) were determined. Cortisol (1.91 µg/dL) and adrenocorticotropic (550 pg/mL) hormone levels were also evaluated. The patient was hospitalized with a diagnosis of acute adrenal crisis due to primary adrenal insufficiency. A Doppler ultrasound revealed venous thrombosis. The patient was diagnosed with antiphospholipid syndrome after the detection of venous thrombosis, thrombocytopenia, elevated aPTT, and anticardiolipin antibody levels. Anticoagulation treatment was started for antiphospholipid syndrome. The patient is now following up with hydrocortisone, fludrocortisone, and warfarin sodium. Conclusion. Antiphospholipid syndrome is a rare reason for adrenal failure. Antiphospholipid syndrome should be suspected if patients have morbidity secondary to venous-arterial thrombosis.
authors.affiliation: Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, 4600 Kahramanmaras, Turkey.
authors.forename: Murat
authors.initials: M
authors.lastname: Sahin
authors.affiliation: Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, 4600 Kahramanmaras, Turkey.
authors.forename: Ayten
authors.initials: A
authors.lastname: Oguz
authors.affiliation: Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, 4600 Kahramanmaras, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Tuzun
authors.affiliation: Clinic of Endocrinology and Metabolism, Necip Fazil State Hospital, 46050 Kahramanmaras, Turkey.
authors.forename: Serife Nur
authors.initials: SN
authors.lastname: Boysan
authors.affiliation: Department of Cardiovascular Surgery, Faculty of Medicine, Kahramanmaras Sutcu Imam University, 4600 Kahramanmaras, Turkey.
authors.forename: Bülent
authors.initials: B
authors.lastname: Mese
authors.affiliation: Clinic of Chest Diseases, Necip Fazil State Hospital, 46050 Kahramanmaras, Turkey.
authors.forename: Hatice
authors.initials: H
authors.lastname: Sahin
authors.affiliation: Department of Endocrinology and Metabolism, Faculty of Medicine, Kahramanmaras Sutcu Imam University, 4600 Kahramanmaras, Turkey.
authors.forename: Kamile
authors.initials: K
authors.lastname: Gul