Adrenal hemorrage secondary to antiphospholipid syndrome causing adrenal insufficiency

Mohamed K.M. Shakir

Walter Reed National Military Medical Center, Bethesda

Scientific Tracks Abstracts: Altern Integr Med

Abstract :

Objective: Antiphospholipid Syndrome (APS) can involve multiple organ systems but endocrine manifestations are rare. In most cases adrenal insufficiency (AI) is the first endocrine manifestation of APS. The prompt diagnosis of adrenal insufficiency is critical as adrenal insufficiency is a life-threatening disease that may lead to fatal outcomes if left untreated. We present a case of AI associated with antiphospholipid syndrome who was managed successfully.

Methods: A literature search was conducted using the databases PubMed and Google Scholar for diagnosis and management of adrenal insufficiency associated with antiphospholipid syndrome.

Results: We describe a 50-year-old male presenting with deep venous thrombosis and pulmonary embolism treated with heparin. The patient subsequently developed hypotension and worsening bilateral flank pain leading to a final diagnosis of adrenal hemorrhage during the course of his hospitalization. Adrenal insufficiency was diagnosed based on serum cortisol and ACTH levels.

Conclusions: In all cases of adrenal hemorrhage and infarction with unknown etiology, screening with lupus anticoagulant and anticardiolipin antibodies is imperative. Recognition of this high mortality condition will allow for appropriate screening and confirmatory tests leading to prompt diagnosis and timely management.

Biography :

Mohamed Shakir MD,MACP,MACE,FRCP, FACN,ECNU, is presently Professor of Medicine, Uniformed University of Health Sciences, Bethesda, MD and staff endocrinologist in the Dept., of Walter Reed National Medical Center. I received my MD degree from All India Institute of Health Sciences, New Delhi and completed residency in Internal Medicine at the University Hospital, New Hersey College of Medicine, Newark, NJ and was followed by a fellowship in Endocrinology, Johns Hopkins Hospital, Baltimore,MD . After completing fellowship I remained at Johns Hopkins as a faculty member and subsequently joined US Navy. I rose through the rank of LCDR to Captain and was Endocrinology Department Head, Program Director and Specialty Leader for Endocrinology, US Navy for 16 years. After spending 6 months at Howard University as the Dept. Head, Endocrinology I returned to Walter Reed National Medical Center as civilian. During my Navy career I received Navy Commendations Medals, Navy Meritorious Service Medal, Navy Antarctica Medal, and National Science Foundation Service medal. I was the past President of Mid- Atlantic Chapter of American Association of Clinical Endocrinology, and Chair Person for Abstract Committee of American Association of Clinical Endocrinology. I am also Master of the American College of Physician, Master of the American Association of Clinical Endocrinology, Fellow of the Royal College of Physicians and Fellow of the American College of Nutrition. My earlier research areas involved signal traction and enzymology but for the last several years I am involved in clinical research in thyroidology. I have published more than 200 papers in peer reviewed journals.

E-mail: mohamed_shakir@hotmail.com