{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,27]],"date-time":"2026-02-27T04:10:35Z","timestamp":1772165435560,"version":"3.50.1"},"reference-count":5,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T00:00:00Z","timestamp":1703116800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T00:00:00Z","timestamp":1703116800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Int J Emerg Med"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Antiphospholipid syndrome causes systemic arterial and venous thromboses due to the presence of antiphospholipid antibodies. Adrenal insufficiency is a rare complication of antiphospholipid syndrome that may result in fatal outcomes if left untreated. Therefore, we report adrenal insufficiency as a rare complication of bilateral adrenal infarction associated with antiphospholipid syndrome and trauma surgery.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Case presentation<\/jats:title>\n                    <jats:p>A 64-year-old male patient underwent surgery for a left traumatic hemothorax. He concurrently had antiphospholipid syndrome and was receiving warfarin. Postoperatively, the patient complained of severe lumbar back pain despite resuming anticoagulation therapy, and he experienced paralytic ileus and shock. Abdominal contrast-enhanced computed tomography revealed adrenal swelling and increased surrounding retroperitoneal adipose tissue density. Diffusion-weighted abdominal magnetic resonance imaging showed high-intensity areas in the bilateral adrenal glands. Cortisol and adrenocorticotropic hormone levels were 3.30\u00a0\u03bcg\/dL and 185.1\u00a0pg\/dL, respectively. Subsequently, the patient was diagnosed with bilateral adrenal infarction and acute adrenal insufficiency, and hydrocortisone was immediately administered. Adrenal insufficiency improved gradually, and the patient was discharged after initiating steroid replacement therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The timing of postoperative anticoagulant therapy initiation remains controversial. Therefore, adrenal insufficiency due to adrenal infarction should be monitored while anticoagulant therapy is discontinued in patients with antiphospholipid syndrome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12245-023-00575-0","type":"journal-article","created":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T05:02:45Z","timestamp":1703134965000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Bilateral adrenal infarction and insufficiency associated with antiphospholipid syndrome and surgery: a case report"],"prefix":"10.1186","volume":"16","author":[{"given":"Yoshihito","family":"Iijima","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Masahito","family":"Ishikawa","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nozomu","family":"Motono","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hidetaka","family":"Uramoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2023,12,21]]},"reference":[{"key":"575_CR1","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.autrev.2018.06.014","volume":"18","author":"KH Lee","year":"2019","unstructured":"Lee KH, Lee H, Lee CH, Kim JY, Kim JM, Kim SS, et al. Adrenal insufficiency in systematic lupus erythematosus (SLE) and antiphospholipid syndrome (APS): a systematic review. Autoimmun Rev. 2019;18:1\u20138.","journal-title":"Autoimmun Rev"},{"key":"575_CR2","doi-asserted-by":"publisher","first-page":"1437","DOI":"10.1210\/jcem.83.5.4833","volume":"83","author":"P Caron","year":"1998","unstructured":"Caron P, Chabannier MH, Cambus JP, Fortenfant F, Otal P, Suc JM. Definitive adrenal insufficiency due to bilateral adrenal hemorrhage and primary antiphospholipid syndrome. J Clin Endocrinol Metab. 1998;83:1437\u20139.","journal-title":"J Clin Endocrinol Metab"},{"key":"575_CR3","first-page":"6538800","volume":"2022","author":"JW Tan","year":"2022","unstructured":"Tan JW, Shukla A, Hu JR, Majumdar SK. Spontaneous adrenal hemorrhage with mild hypoadrenalism in a patient anticoagulated with apixaban for antiphospholipid syndrome: a case report and literature review. Case Rep Endocrinol. 2022;2022:6538800.","journal-title":"Case Rep Endocrinol"},{"key":"575_CR4","doi-asserted-by":"publisher","first-page":"299","DOI":"10.1034\/j.1600-0609.2003.00145.x","volume":"71","author":"K Berneis","year":"2003","unstructured":"Berneis K, Buitrago-T\u00e9llez C, M\u00fcller B, Keller U, Tsakiris DA. Antiphospholipid syndrome and endocrine damage: why bilateral adrenal thrombosis? Eur J Haematol. 2003;71:299\u2013302.","journal-title":"Eur J Haematol"},{"key":"575_CR5","doi-asserted-by":"publisher","first-page":"e326S","DOI":"10.1378\/chest.11-2298","volume":"141","author":"JD Douketis","year":"2012","unstructured":"Douketis JD, Spyropoulos AC, Spencer FA, Mayr M, Jaffer AK, Eckman MH, et al. Perioperative management of antithrombotic therapy: antithrombotic therapy and prevention of thrombosis, 9th ed: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines. Chest. 2012;141:e326S \u2013 e350.","journal-title":"Chest"}],"container-title":["International Journal of Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12245-023-00575-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12245-023-00575-0\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12245-023-00575-0.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,21]],"date-time":"2023-12-21T05:02:50Z","timestamp":1703134970000},"score":1,"resource":{"primary":{"URL":"https:\/\/intjem.biomedcentral.com\/articles\/10.1186\/s12245-023-00575-0"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,12,21]]},"references-count":5,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["575"],"URL":"https:\/\/doi.org\/10.1186\/s12245-023-00575-0","relation":{"has-preprint":[{"id-type":"doi","id":"10.21203\/rs.3.rs-3134797\/v1","asserted-by":"object"}]},"ISSN":["1865-1380"],"issn-type":[{"value":"1865-1380","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,12,21]]},"assertion":[{"value":"3 July 2023","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 December 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 December 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Written informed consent was obtained from the patient for the publication of this report and its accompanying images.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"93"}}