Zeitschrift für Rheumatologie

, Volume 76, Issue 2, pp 170–175 | Cite as

Adrenal gland abnormalities detected by magnetic resonance imaging in patients with antiphospholipid syndrome

  • A. A. Shahin
  • S. M. El Desouky
  • M. Y. Awadallah
  • D. E. Megahed
Originalien
  • 132 Downloads

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.

Keywords

Antiphospholipid syndrome Adrenal glands MRI Adrenal infarction Antiphospholipid antibodies 

Magnetresonanztomographisch detektierte Nebennierenanomalien bei Patienten mit Antiphospholipidsyndrom

Zusammenfassung

Hintergrund

Ein Nebenniereninfarkt ist eine seltene Komplikation bei Antiphospholipidsyndrom (APS).

Zielsetzung

Ziel der vorliegenden Studie ist die Untersuchung von MRT(Magnetresonanztomographie)-Befunden der Nebennieren in einer Gruppe von APS-Patienten.

Material und Methoden

In dieser Querschnittsstudie wurden die von 20 Patienten mit primären oder sekundären APS mit denen von 20 SLE(systemischer Lupus erythematosus)-Patienten ohne Antiphospholipidantikörper (aPL) verglichen. Durchgeführt wurden abdominelle MRTs mit Darstellung der Nebennieren.

Ergebnisse

Von allen Patienten waren 80% Frauen mit einem Durchschnittsalter 32,45 ± 9,93 Jahre, die mittlere Krankheitsdauer lag bei 46,65 ± 58,71 Monaten. In den MRTs wurden bei 35 % der APS-Patienten Anomalien detektiert, im SLE-Kontrollkollektiv dagegen bei keinem. Eine Vergrößerung der Nebenniere bestand bei allen Patienten (35 %), ein kapsuläres Enhancement (Infarkt bzw. hämorrhagischer Infarkt) bei 5, vermehrtes Stranding im periadrenalen Fettgewebe (entzündlicher Prozess) bei 4 und erhöhte T1W- und T2W-Signalwerte (Blutung) bei 3 Patienten. Von den Patienten mit adrenaler Beteiligung wiesen 71,4 % eine Triple-aPL-Positivität auf, von den Patienten mit unauffälligen Nebennierenbefunden dagegen nur 23,1% (p = 0,04).

Schlussfolgerungen

Nebennierenanomalien wurden magnetresonanztomographisch bei 35 % der APS-Patienten nachgewiesen, was die Notwendigkeit einer stärkeren Fokussierung auf das entsprechende Management verdeutlicht. Hinsichtlich des Patientenmanagements ist dieser nicht unerhebliche Prozentsatz zu bedenken.

Schlüsselwörter

Antiphospholipidsyndrom Nebennieren Magnetresonanztomographie Nebenniereninfarkt Antiphospholipid-Antikörpern 

Notes

Compliance with ethical guidelines

Conflict of interest

A. A. Shahin, S. M. El Desouky, M. Y. Awadallah, and D. E. Megahed state that there are no conflicts of interest.

The accompanying manuscript does not include studies on humans or animals.

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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • A. A. Shahin
    • 1
  • S. M. El Desouky
    • 1
  • M. Y. Awadallah
    • 2
  • D. E. Megahed
    • 1
  1. 1.Rheumatology and Rehabilitation Department, Faculty of MedicineCairo UniversityGizaEgypt
  2. 2.Radiology Department, Faculty of MedicineCairo UniversityCairoEgypt

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