Adrenal gland abnormalities detected by magnetic resonance imaging in patients with antiphospholipid syndrome.
BACKGROUND
Adrenal infarction is a rare complication of antiphospholipid syndrome (APS).


OBJECTIVE
The purpose of the current study is to detect and study the magnetic resonance imaging (MRI) findings of adrenal glands in APS patients.


METHODS
In a cross-sectional study, the data of 20 patients with primary or secondary APS were compared to 20 SLE patients without antiphospholipid antibody (aPL) syndrome (controls). MRI of the abdomen showing the adrenal glands was performed.


RESULTS
Of the patients, 80% were females with a mean age 32.45 ± 9.93 years, and mean disease duration of 46.65 ± 58.71 months. Adrenal gland abnormalities in the MRI study were detected in 35 % of APS patients vs. no abnormalities detected in the SLE controls. Adrenal gland enlargement was found in all patients (35 %). Capsular enhancement (infarction or hemorrhagic infarction) was found in 5 patients, increased stranding of the surrounding fat planes (inflammatory process) in 4 patients and increased signal on T1WI and T2WI (hemorrhage) in 3 patients. In patients with adrenal gland involvement, 71.4 % had triple aPL positivity compared to 23.1 % in patients with normal adrenal findings (p = 0.04).


CONCLUSIONS
Adrenal gland abnormalities on MRI were detected in 35 % of the APS patients (whether primary or secondary); thus, increased focus on management is needed. This percentage is not small and needs to be focused on in terms of management.
Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, 453 alharam st., Giza, Egypt. amirashahin@hotmail.com.
A A
AA
Shahin
Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, 453 alharam st., Giza, Egypt.
S M
SM
El Desouky
Radiology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
M Y
MY
Awadallah
Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, 453 alharam st., Giza, Egypt.
D E
DE
Megahed
D000311:Adrenal Glands / Q000000981:diagnostic imaging* / Q000473:pathology*; D000328:Adult; D016736:Antiphospholipid Syndrome / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D015984:Causality; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003937:Diagnosis, Differential; D004534:Egypt / Q000453:epidemiology; D005260:Female; D006801:Humans; D007238:Infarction / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D008279:Magnetic Resonance Imaging / Q000706:statistics & numerical data*; D008297:Male; D015995:Prevalence; D015203:Reproducibility of Results; D012307:Risk Factors; D012680:Sensitivity and Specificity; D017678:Sex Distribution
Adrenal glands; Adrenal infarction; Antiphospholipid antibodies; Antiphospholipid syndrome; MRI