ABSTRACT
Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by
thrombotic tendency that affects most organ systems in the human body. In this report,
we present a review of the endocrinologic manifestations associated with APS by evaluating
the medical literature from 1968 to 2009 using MEDLINE and these keywords: APS, antiphospholipid syndrome, antiphospholipid antibodies, anticardiolipin antibodies,
lupus anticoagulant, anti β-2 glycoprotein I, pituitary, adrenal, thyroid, parathyroid,
ovary, testes, diabetes mellitus, and diabetes insipidus. Adrenal insufficiency was found to be the most common endocrine manifestation associated
with APS. Autoimmune thyroid disease was associated with increased titers of antiphospholipid
antibodies (aPL) without any APS clinical manifestations. In addition, hypopituitarism
and Sheehan syndrome are increasingly being reported in association with aPL. Data
regarding the prevalence and significance of aPL in diabetic patients remains uncertain.
Finally, only a few cases of ovarian and testicular derangements have been reported.
APS should be considered in any patient with adrenal insufficiency even in the absence
of other thrombotic manifestations. It is also advisable to assess aPL in the sera
of patients presenting with pituitary insufficiency. Further studies are needed to
clarify the relationship between aPL and thyroid disorders and diabetes mellitus.
KEYWORDS
Antiphospholipid syndrome - adrenal - pituitary - thyroid - diabetes
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Imad W UthmanM.D. M.P.H.
Department of Internal Medicine, American University of Beirut Medical Center
PO Box 11-0236, Riad El-Solh 1107, 2020 Beirut, Lebanon
Email: iuthman@aub.edu.lb
