Adrenal crisis due to bilateral adrenal hemorrhage in primary antiphospholipid syndrome.
Ringkananon, Usanee; Khovidhunkit, Weerapan; Vongthavaravat, Varaphon; Sridama, Vitaya; Lalitanantpong, Siripon; Snabboon, Thiti.
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| IMSEAR | ID: sea-42860
The authors report a case of a 56-year-old Thai woman with a history of recurrent venous thrombosis, spontaneous abortion and Graves' disease who presented with bilateral flank pain, nausea, vomiting and low-grade fever followed by hypotension. Adrenal crisis from bilateral adrenal hemorrhage was diagnosed by a low serum cortisol level during hypotension and bilateral hyperdense oval masses in each of the adrenal glands in a computerized tomographic study. Her hemostatic and serologic profile was compatible with primary antiphospholipid syndrome. Rapid improvement was observed after the administration of intravenous hydrocortisone. She was discharged on long-term glucocorticoid replacement for her primary adrenal insufficiency as well as an anticoagulant for prevention of thrombosis. The antiphospholipid syndrome should be suspected in a patient presenting with adrenal crisis without a distinct etiology.
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