Published in:
Open Access
01-12-2005 | Case report
Adrenal failure followed by status epilepticus and hemolytic anemia in primary antiphospholipid syndrome
Authors:
Patrick Gerner, Michael Heldmann, Peter Borusiak, Vladimir Bures, Stefan Wirth
Published in:
Thrombosis Journal
|
Issue 1/2005
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Abstract
We report on a 14 year old boy who presented with the symptoms abdominal pain, fever and proteinuria. A hematoma in the region of the right pararenal space was diagnosed. Prothrombin time and activated partial thromboplastin time were prolonged, lupus anticoagulant and anticardiolipin antibodies were positive and serum cortisol was normal. Ten days after admission the boy suddenly suffered generalized seizures due to low serum sodium. As well, the patient developed hemolytic anemia, acute elevated liver enzymes, hematuria and increased proteinuria. At this time a second hemorrhage of the left adrenal gland was documented. Adrenal function tests revealed adrenal insufficiency. We suspected microthromboses in the adrenals and secondary bleeding and treated the boy with hydrocortisone, fludrocortisone and phenprocoumon.
Conclusion
Adrenal failure is a rare complication of APS in children with only five cases reported to date. As shown in our patient, this syndrome can manifest in a diverse set of simultaneously occurring symptoms.