Adrenal Failure: When Antiphospholipid Syndrome Leaves Scars

This case report discusses a 56-year-old male diagnosed with systemic lupus erythematosus (SLE) and antiphospholipid syndrome (APS), presenting with primary adrenal insufficiency (PAI) due to adrenal gland involvement. The patient exhibited symptoms such as extreme fatigue, anorexia, and significant weight loss, alongside laboratory findings of anemia, thrombocytopenia, and elevated inflammatory markers. Imaging revealed intense uptake and necrosis in the adrenal glands, leading to a diagnosis of PAI. Treatment with intravenous hydrocortisone and subsequent medications, including prednisolone, fludrocortisone, warfarin, hydroxychloroquine, and azathioprine, resulted in clinical improvement and stabilization. This case highlights the rare but severe impact of APS on the adrenal glands, emphasizing the need for early diagnosis, treatment, and a multidisciplinary approach to improve outcomes.