Linked Life Data

12640187

Source:http://linkedlifedata.com/resource/pubmed/id/12640187

Statements in which the resource exists as a subject.
PredicateObject
rdf:type
lifeskim:mentions
pubmed:issue
2
pubmed:dateCreated
2003-3-17
pubmed:abstractText
To describe the clinical and immunologic characteristics of patients with adrenal involvement and antiphospholipid syndrome (APS), we conducted a computer-assisted (PubMed) search of the literature to identify all cases of primary adrenal insufficiency associated with antiphospholipid antibodies published in English, French, and Spanish from 1983 (when APS was first defined) through March 2002. We reviewed 86 patients (80 from the literature plus 6 from our cohort); 55% were male, and the mean age at presentation was 43 +/- 16 years. Sixty-one (71%) patients had primary APS, and 14 (16%) had systemic lupus erythematosus. In 31 (36%) patients, adrenal insufficiency was the first clinical manifestation of APS. Abdominal pain was present in 55% of patients, followed by hypotension (54%), fever (40%), nausea or vomiting (31%), weakness or fatigue (31%), and lethargy or altered mental status (19%). The main finding in imaging techniques was compatible with adrenal hemorrhage (59%) and in histopathologic study was a hemorrhagic infarction with vessel thrombosis (55%). Lupus anticoagulant was detected in 97% of patients and the anticardiolipin antibodies titer was positive in 93% of patients. Most patients (95%) were positive for the IgG isotype of anticardiolipin antibodies, whereas 40% were positive for the IgM isotype. Baseline cortisol levels were decreased in 98% of patients, ACTH hormone levels were increased in 96% of patients, and the cosyntropin stimulation test was positive in 100% of patients tested. Steroid replacement therapy was the most frequent treatment (84%), followed by anticoagulation (52%) and aspirin (6%). Thirty-two of 35 (91%) patients with prolonged anticoagulant therapy were in good health with a mean follow-up of 25 months, whereas 25 of the 69 (36%) patients with outcome data available had died. The results of the present review stress the clinical importance of systematic screening for lupus anticoagulant and anticardiolipin antibodies in all cases of adrenal hemorrhage or infarction. An initial screening for hypoadrenalism is mandatory in any antiphospholipid antibody-positive patient who complains of abdominal pain and undue weakness or asthenia.
pubmed:language
eng
pubmed:journal
pubmed:citationSubset
AIM
pubmed:chemical
pubmed:status
MEDLINE
pubmed:month
Mar
pubmed:issn
0025-7974
pubmed:author
pubmed:issnType
Print
pubmed:volume
82
pubmed:owner
NLM
pubmed:authorsComplete
Y
pubmed:pagination
106-18
pubmed:dateRevised
2006-11-15
pubmed:meshHeading
pubmed-meshheading:12640187-Abdominal Pain, pubmed-meshheading:12640187-Adolescent, pubmed-meshheading:12640187-Adrenal Glands, pubmed-meshheading:12640187-Adrenal Insufficiency, pubmed-meshheading:12640187-Adult, pubmed-meshheading:12640187-Aged, pubmed-meshheading:12640187-Antibodies, Anticardiolipin, pubmed-meshheading:12640187-Anticoagulants, pubmed-meshheading:12640187-Antiphospholipid Syndrome, pubmed-meshheading:12640187-Child, pubmed-meshheading:12640187-Female, pubmed-meshheading:12640187-Glucocorticoids, pubmed-meshheading:12640187-Humans, pubmed-meshheading:12640187-Immunoglobulin Isotypes, pubmed-meshheading:12640187-Immunosuppressive Agents, pubmed-meshheading:12640187-Lupus Coagulation Inhibitor, pubmed-meshheading:12640187-Male, pubmed-meshheading:12640187-Middle Aged, pubmed-meshheading:12640187-Plasmapheresis, pubmed-meshheading:12640187-Tomography, X-Ray Computed, pubmed-meshheading:12640187-Treatment Outcome
pubmed:year
2003
pubmed:articleTitle
Adrenal involvement in the antiphospholipid syndrome: clinical and immunologic characteristics of 86 patients.
pubmed:affiliation
Department of Autoimmune Diseases, Institut Clínic d'Infeccions i Immunologia, Institut d'Investigacions Biomèdiques August Pi Sunyer, Hospital Clínic, Barcelona, Catalonia, Spain.
pubmed:publicationType
Journal Article, Review, Case Reports, Research Support, Non-U.S. Gov't