Division of Rheumatology, American University of Beirut, Beirut, Lebanon.
Semin Thromb Hemost. 2011 Feb;37(1):49-57. doi: 10.1055/s-0030-1270071.
Antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by thrombotic tendency that affects most organ systems in the human body. In this report, we present a review of the endocrinologic manifestations associated with APS by evaluating the medical literature from 1968 to 2009 using MEDLINE and these keywords: APS, antiphospholipid syndrome, antiphospholipid antibodies, anticardiolipin antibodies, lupus anticoagulant, anti β-2 glycoprotein I, pituitary, adrenal, thyroid, parathyroid, ovary, testes, diabetes mellitus, and diabetes insipidus. Adrenal insufficiency was found to be the most common endocrine manifestation associated with APS. Autoimmune thyroid disease was associated with increased titers of antiphospholipid antibodies (aPL) without any APS clinical manifestations. In addition, hypopituitarism and Sheehan syndrome are increasingly being reported in association with aPL. Data regarding the prevalence and significance of aPL in diabetic patients remains uncertain. Finally, only a few cases of ovarian and testicular derangements have been reported. APS should be considered in any patient with adrenal insufficiency even in the absence of other thrombotic manifestations. It is also advisable to assess aPL in the sera of patients presenting with pituitary insufficiency. Further studies are needed to clarify the relationship between aPL and thyroid disorders and diabetes mellitus.
抗磷脂综合征(APS)是一种全身性自身免疫性疾病,以血栓倾向为特征,影响人体的大多数器官系统。在本报告中,我们通过评估 1968 年至 2009 年的 MEDLINE 医学文献,使用了 APS、抗磷脂综合征、抗磷脂抗体、抗心磷脂抗体、狼疮抗凝剂、抗β-2 糖蛋白 I、垂体、肾上腺、甲状腺、甲状旁腺、卵巢、睾丸、糖尿病、尿崩症这些关键字,对与 APS 相关的内分泌表现进行了综述。结果发现,肾上腺功能不全是与 APS 相关的最常见的内分泌表现。自身免疫性甲状腺疾病与抗磷脂抗体(aPL)滴度升高有关,但无任何 APS 临床表现。此外,垂体功能减退症和希恩氏综合征与 aPL 的相关性也越来越受到关注。关于糖尿病患者中 aPL 的患病率和意义的数据仍不确定。最后,仅有少数卵巢和睾丸功能紊乱的病例报道。即使没有其他血栓表现,任何患有肾上腺功能不全的患者都应考虑 APS。对出现垂体功能减退的患者的血清进行 aPL 评估也是可取的。还需要进一步的研究来阐明 aPL 与甲状腺疾病和糖尿病之间的关系。