PMID: 19915297Nov 17, 2009Paper

Secondary adrenal insufficiency and primary antiphospholipid syndrome

Internal Medicine
Eman M Alfadhli

Abstract

A woman with isolated ACTH deficiency and empty sella in a background of primary antiphospholipid syndrome (APS) is described. A 24-year-old woman was admitted for premature delivery at 30 weeks of gestation and was found to have severe pulmonary hypertension and right sided heart failure. A few hours after delivery, without excessive blood loss, she suddenly lost consciousness, and was found to be hypotensive and hypoglycemic. The findings on hormonal evaluation were consistent with isolated secondary adrenal insufficiency as both ACTH and cortisol levels were very low. Magnetic resonance imaging of the pituitary fossa showed an empty sella. Her severe cor pulmonale was found to be due to primary APS. The patient was given replacement of glucocorticoid and treated with frusemide, spironolactone, warfarin, sildenafil and inhaled iloprost for her pulmonary hypertension, after which her clinical status improved substantially. Follow-up tests of the hypothalamic-pituitary axis found normal serum LH, FSH, TSH, FT4 and prolactin secretion; serum ACTH and plasma cortisol levels remained low.

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Citations

Dec 24, 2015·Pulmonary Circulation·Matthew MollHarrison W Farber
Nov 26, 2010·International Journal of Cardiology·Jun IkariKoichiro Tatsumi
Jul 22, 2020·The Journal of International Medical Research·Katarina Mlekuš KozamernikMarija Pfeifer
Feb 15, 2012·Gynecological Endocrinology : the Official Journal of the International Society of Gynecological Endocrinology·N K AgrawalSunny Garg

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Antiphospholipid Syndrome

Antiphospholipid syndrome or antiphospholipid antibody syndrome (APS or APLS), is an autoimmune, hypercoagulable state caused by the presence of antibodies directed against phospholipids.

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Addison's disease, also known as primary adrenal insufficiency and hypocortisolism, is a long-term endocrine disorder in which the adrenal glands do not produce enough steroid hormones. Discover the latest research on Addison's disease here.

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