Hypopituitarism in a woman with a severe primary antiphospholipid syndrome

The antiphospholipid syndrome (APS) is an acquired thrombotic disorder characterised by recurrent venous or artery thromboses or recurrent miscarriages, or both, associated with the presence of antibodies directed against negatively charged phospholipids—that is, lupus anticoagulant (LA), or anticardiolipin antibodies (aCL), or phospholipid binding proteins, or all three.1 It mainly occurs within systemic lupus erythematosus or as a primary disorder.1 Nearly all organs or tissues may be involved by thrombosis, but to date endocrine manifestations of the APS are mainly restricted to acute or chronic adrenal insufficiency resulting from adrenal haemorrhagic infarctions.2 We describe the case of a patient with primary APS who developed hypopituitarism assumed to result from hypothalamic dysfunction. A 48 year old woman was referred in 1996 for asthenia and a weight gain of 8 kg during the last six months. Her past medical history included two normal pregnancies in 1966 and 1970 and the chance discovery of LA in 1976, which remained present on subsequent determinations. She had experienced four fetal …