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Year : 2006  |  Volume : 8  |  Issue : 2  |  Page : 77-80

Multiple Endocrine Abnormalities In A Patient With Primary Antiphospholipid Syndrome



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B Kulshreshtha


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Endocrine abnormalities are an uncommon accompaniment of Antiphospholipid syndrome. We describe this rare syndrome in association with a triad of diabetes, subclinical hypothyroidism and adrenal insufficieny. A 37 year old diabetic male presented with complaints of recurrent hypoglycemias and a decline in the requirement of his antidiabetic medications. He had a history of hyperpigmentation and recurrent abdominal pain, which had improved with seteroids. He had been having chronic non healing bilateral lower limb venous ulcers with recurrent crural deep venous thrombosis. History and investigations suggested repeated episodes of pulmonary thromboembolism. His present clinical status showed evidence of right heart failure and pulmonary arterial hypertension. Investigations confirmed the diagnosis of primary antiphospholipid syndrome. Endocrine abnormalities included cortisol insufficiency with bilateral adrenal atrophy and a primary subclinical hypothyroidism with mildly positive antithyroid peroxidase antibodies. He had a type 2 diabetes mellitus with a positive family history of diabetes and a negative anti GAD autoantibody screen. Thus our patient had type 2 diabetes, cortisol insufficiency and primary subclinical hypothyroidism. To the best of our knowledge, this combination of endocrine abnormalities is being described in association with primary APS for the first time.


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