Primary Adrenal Insufficiency

Primary adrenal insufficiency occurring in patients with the antiphospholipid syndrome is described. However, primary adrenal insufficiency as a presenting manifestation of antiphospholipid syndrome (APLS) is rarely described. We report a patient in whom initially the diagnosis of APLS was not thought of because of its presentation as a primary adrenal insufficiency; however, the etiology of primary adrenal failure could not be ascertained. Later on, when he presented with recurrent deep vein thrombosis, diagnosis of APLS was considered and investigated accordingly. This case highlights the importance of having a high index of suspicion for diagnosis of primary APLS in patients with primary adrenal insufficiency when no other definite etiology is evident.