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Primary antiphospholipid syndrome associated with postoperative primary adrenal failure
K I Papadopoulos1, A Jönsson, E Berntorp
1Department of Endocrinology, Lund University Clinics, General Hospital, Malmö, Sweden.
Journal of Internal Medicine
|August 1, 1995
Summary
A patient developed autoimmune hemolytic anemia and thrombocytopenia after surgery, diagnosed as antiphospholipid syndrome. This case highlights antiphospholipid syndrome presenting with primary adrenal failure due to adrenal hemorrhage.
Area of Science:
- Internal Medicine
- Hematology
- Endocrinology
Background:
- Antiphospholipid syndrome (APS) is an autoimmune disorder characterized by recurrent thrombosis or pregnancy morbidity.
- Primary adrenal insufficiency, or Addison's disease, can result from various causes, including hemorrhage.
Observation:
- A 51-year-old male presented with Coomb's positive hemolytic anemia, thrombocytopenia, transient paranoid psychosis, and bilateral adrenal hemorrhage post-inguinal hernia surgery.
- Laboratory findings included a prolonged activated partial thromboplastin time, lupus anticoagulant, and anticardiolipin antibodies.
Findings:
- The patient was diagnosed with primary antiphospholipid syndrome in the absence of criteria for systemic lupus erythematosus (SLE).
- The adrenal hemorrhage led to primary adrenal failure, necessitating cortisone substitution therapy.
Implications:
- This case demonstrates a rare presentation of primary antiphospholipid syndrome associated with primary adrenal failure secondary to adrenal hemorrhage.
- Early recognition and management of antiphospholipid syndrome and its complications are crucial for patient outcomes.