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Adrenal Insufficiency After Laparoscopic Hysterectomy in a Patient With Primary Antiphospholipid Syndrome

From the ¹Department of Obstetrics and Gynecology, and ²Division of Endocrinology, New York University, New York, New York.

ABSTRACT

BACKGROUND: We report a case of bilateral adrenal hemorrhage and subsequent adrenal insufficiency after a laparoscopic hysterectomy in a patient with anticardiolipin antibody syndrome.

CASE: A 55-year-old woman with a history of anticardiolipin antibody syndrome presented with nausea and vomiting 1 week after laparoscopic hysterectomy and staging for endometrial adenocarcinoma. Based on a diagnosis of adrenal insufficiency, the patient was started on oral hydrocortisone 20 mg in the morning and 10 mg in the afternoon, and fludrocortisone 0.05 mg twice daily on day 5. Her symptoms resolved completely within 24 hours of beginning steroids.

CONCLUSION: The diagnosis of adrenal insufficiency should be entertained in any patient with a history of thrombophilias presenting with general abdominal complaints.