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Antiphospholipid syndrome and endocrine damage: why bilateral adrenal thrombosis?
JournalArticle (Originalarbeit in einer wissenschaftlichen Zeitschrift)
 
ID 3188594
Author(s) Berneis, Kaspar; Buitrago-Tellez, Carlos; Muller, Beat; Keller, Ulrich; Tsakiris, Dimitrios A.
Author(s) at UniBasel Keller, Ulrich O.
Müller, Beat
Year 2003
Title Antiphospholipid syndrome and endocrine damage: why bilateral adrenal thrombosis?
Journal European Journal of Haematology
Volume 71
Number 4
Pages / Article-Number 299-302
Keywords antiphospholipid antibodies, adrenal failure, late endosomes
Abstract We describe a rare case of bilateral hemorrhagic infarction of the adrenal glands diagnosed in the context of positive antiphospholipid antibodies (aPL). The patient presented atypical clinical symptoms of adrenal insufficiency. Laboratory investigation showed complete adrenal failure and increased aPL, both manifestations persisted 1 yr after the initial event. MR imaging at baseline was compatible with bilateral hemorrhagic infarction and showed almost complete loss of viable adrenal tissue 1 yr later. Although no direct causal effect can be proved, the sequence of events and the exclusion of other common causes of bilateral adrenal hemorrhage (e.g. tuberculosis, severe coagulation disorder) support an association between aPL and adrenal hemorrhagic infarction. A unique link between particular anatomical characteristics of the adrenal fascicular zone and a novel, previously described, explanation model of aPL-thrombosis is hypothesized. It is based on the properties of late endosomes, which are important organelles participating in cholesterol trafficking and protein sorting within cells and express epitopes recognized by aPL. It would be interesting to investigate adrenal tissue for presence of late endosomes and their aPL relevant epitopes for proof of this tempting hypothesis. Focal accumulation of aPL and isolated, simultaneous, bilateral adrenal infarctions could thus be explained.
Publisher Wiley
ISSN/ISBN 0902-4441 ; 1600-0609
edoc-URL http://edoc.unibas.ch/dok/A6419967
Full Text on edoc No
Digital Object Identifier DOI 10.1034/j.1600-0609.2003.00145.x
PubMed ID http://www.ncbi.nlm.nih.gov/pubmed/12950241
ISI-Number WOS:000185115300011
Document type (ISI) Journal Article
 
   

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29/03/2024