[Acute adrenal insufficiency caused by bilateral adrenal hemorrhage as first manifestation of antiphospholipid syndrome. Report of a case and review].
Although adrenal hemorrhage is an unusual feature of antiphospholipid syndrome (APS), it can be its first clinical manifestation. The pathogenetic substratum is the thrombosis of the adrenal veins leading to hemorrhagic infarction. Recurrences are frequent in patients with APS-related thrombosis, thus long-term anticoagulation is advocated by most authors.