Adrenal failure and antiphospholipid syndrome

Area of Science:

• Endocrinology
• Rheumatology
• Internal Medicine

Background:

• Antiphospholipid syndrome (APS) is an autoimmune disorder associated with an increased risk of thrombosis and pregnancy complications.
• Primary adrenal insufficiency (AI) is a condition where the adrenal glands do not produce enough steroid hormones.
• The association between APS and AI is rare but clinically significant.

Purpose of the Study:

• To report two cases of primary AI in patients with APS.
• To emphasize the importance of recognizing AI in patients with APS.
• To highlight key diagnostic clues and clinical considerations.

Main Methods:

• Case report of two patients with AI and APS.
• Clinical presentation, diagnostic findings, and disease course were analyzed.
• Literature review on the association between AI and APS.

Main Results:

• Both patients presented with hyponatremia as a primary diagnostic finding for AI.
• AI onset varied: acute in one patient coinciding with APS diagnosis, and subacute/chronic in another, unmasked by stress.
• The time course of AI development relative to APS differed significantly between the two cases.

Conclusions:

• Clinicians should consider AI in patients with suspected or established APS, especially if presenting with hyponatremia, hypotension, fever, or abdominal complaints.
• Patients with primary AI should be evaluated for APS symptoms.
• Early recognition and management of AI in APS patients are critical for patient outcomes.