A A Shahin1, S M El Desouky2, M Y Awadallah3, D E Megahed2. 1. Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, 453 alharam st., Giza, Egypt. amirashahin@hotmail.com. 2. Rheumatology and Rehabilitation Department, Faculty of Medicine, Cairo University, 453 alharam st., Giza, Egypt. 3. Radiology Department, Faculty of Medicine, Cairo University, Cairo, Egypt.
Abstract
BACKGROUND: Adrenal infarction is a rare complication of antiphospholipid syndrome (APS). OBJECTIVES: The purpose of the current study is to detect and study the magnetic resonance imaging (MRI) findings of adrenal glands in APS patients. MATERIALS AND METHODS: In a cross-sectional study, the data of 20 patients with primary or secondary APS were compared to 20 SLE patients without antiphospholipid antibody (aPL) syndrome (controls). MRI of the abdomen showing the adrenal glands was performed. RESULTS: Of the patients, 80% were females with a mean age 32.45 ± 9.93 years, and mean disease duration of 46.65 ± 58.71 months. Adrenal gland abnormalities in the MRI study were detected in 35 % of APS patients vs. no abnormalities detected in the SLE controls. Adrenal gland enlargement was found in all patients (35 %). Capsular enhancement (infarction or hemorrhagic infarction) was found in 5 patients, increased stranding of the surrounding fat planes (inflammatory process) in 4 patients and increased signal on T1WI and T2WI (hemorrhage) in 3 patients. In patients with adrenal gland involvement, 71.4 % had triple aPL positivity compared to 23.1 % in patients with normal adrenal findings (p = 0.04). CONCLUSIONS: Adrenal gland abnormalities on MRI were detected in 35 % of the APS patients (whether primary or secondary); thus, increased focus on management is needed. This percentage is not small and needs to be focused on in terms of management.
BACKGROUND:Adrenal infarction is a rare complication of antiphospholipid syndrome (APS). OBJECTIVES: The purpose of the current study is to detect and study the magnetic resonance imaging (MRI) findings of adrenal glands in APSpatients. MATERIALS AND METHODS: In a cross-sectional study, the data of 20 patients with primary or secondary APS were compared to 20 SLEpatients without antiphospholipid antibody (aPL) syndrome (controls). MRI of the abdomen showing the adrenal glands was performed. RESULTS: Of the patients, 80% were females with a mean age 32.45 ± 9.93 years, and mean disease duration of 46.65 ± 58.71 months. Adrenal gland abnormalities in the MRI study were detected in 35 % of APSpatients vs. no abnormalities detected in the SLE controls. Adrenal gland enlargement was found in all patients (35 %). Capsular enhancement (infarction or hemorrhagic infarction) was found in 5 patients, increased stranding of the surrounding fat planes (inflammatory process) in 4 patients and increased signal on T1WI and T2WI (hemorrhage) in 3 patients. In patients with adrenal gland involvement, 71.4 % had triple aPL positivity compared to 23.1 % in patients with normal adrenal findings (p = 0.04). CONCLUSIONS:Adrenal gland abnormalities on MRI were detected in 35 % of the APSpatients (whether primary or secondary); thus, increased focus on management is needed. This percentage is not small and needs to be focused on in terms of management.
Authors: Gerard Espinosa; Eugénia Santos; Ricard Cervera; Jean-Charles Piette; Gloria de la Red; Víctor Gil; Josep Font; Robert Couch; Miguel Ingelmo; Ronald A Asherson Journal: Medicine (Baltimore) Date: 2003-03 Impact factor: 1.889
Authors: Khaled M Elsayes; Govind Mukundan; Vamsidhar R Narra; James S Lewis; Ali Shirkhoda; Aamer Farooki; Jeffrey J Brown Journal: Radiographics Date: 2004-10 Impact factor: 5.333