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Acute adrenal failure associated with primary antiphospholipid syndrome and homozygosity for MTHFR C677T
Anastasios Mavridis1, Marina Skopeliti, Panagiota Galani
1The First Department of Internal Medicine, Amalia Fleming General Hospital, Greece.
Abstract:
A 47-year-old woman with a recent clinical diagnosis of acute cholecystitis developed acute adrenal failure. Initial computed tomograms of the abdomen showed bilateral adrenal swelling which evolved into bilateral adrenal hemorrhage on repeat examination a few days later. Laboratory investigations revealed a previously undiagnosed primary antiphospholipid syndrome and homozygosity for the MTHFR C677T mutation with hyperhomocysteinemia. This case highlights the protean clinical manifestations of adrenal vascular accidents and the need for a thorough search for underlying prothrombotic states in this setting.
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