ANTIPHOSPHOLIPID ANTIBODY SYNDROME AND ADRENAL INSUFFICIENCY IN A 15-YEAR-OLD GIRL

Antiphospholipid syndrome is increasingly recognized in children. This syndrome is manifested by arterial or venous thromboses, recurrent fe tal loss, the presence of elevated titers of anticardiolipin antibodie s, and/or the presence of a lupus anticoagulant. Adrenal insufficiency as a complication of this syndrome is rare. We describe adrenal insuf ficiency in a 15-year-old girl with a lupus anticoagulant and review t his complication of the antiphospholipid syndrome in pediatric patient s. Adrenal insufficiency is typically manifested by abdominal pain, hy potension, fever, and vomiting. Evaluation reveals hyponatremia, hyper kalemia, and metabolic acidosis. When suspected, adrenal insufficiency should be confirmed by a corticotrophin stimulation test. Prompt mana gement of fluid and electrolyte disturbance along with the replacement of glucocorticoids and mineralocorticoids is necessary to treat this potentially fatal disorder in pediatric patients.