Bilateral adrenal haemorrhage with adrenal insufficiency in primary antiphospholipid antibody syndrome

We report a case of acute adrenal insufficiency in a context of probable bi lateral adrenal haemorrhage, as revealed by CT-scan in a 52-year-old woman with a history of spontaneous abortion and repeated ischaemic stroke withou t symptoms or signs of collagen vascular disease. The symptoms began after the patient had successfully been treated for pneumonia. She had persistent ly high titres of IgG anticardiolipin antibodies, antibodies against beta(2 )-glycoprotein I and a lupus anticoagulant. The diagnosis of primary antiph ospholipid syndrome with adrenal insufficiency was postulated.