Abdominal Pain and Severe Hyponatremia After Lung Cancer Surgery

Adrenal failure and antiphospholipid syndrome

We herein report two cases of primary adrenal insufficiency (AI) associated with antiphospholipid syndrome (APS). In both patients, the main finding that led to the diagnosis was hyponatraemia. The major difference between the two cases was the time at which AI evolved during the course of APS. In the first patient, AI developed acutely along with other presenting features of APS. In the second patient, the AI was unmasked during a stressful situation induced by severe inflammation that occurred 7 years after the first APS manifestation and had probably evolved slowly during the previous few years. These cases emphasise the importance of considering AI in patients with either suspected or newly diagnosed APS as well as in patients who have long been known to have APS. The symptoms and signs alerting the clinician to possible AI are general abdominal complaints, fever, hypotension, and hyponatraemia. Conversely, patients with primary AI should be questioned about the signs and symptoms of APS.

Adrenal Insufficiency Due to Bilateral Adrenal Non-Hodgkin's Lymphoma: A Case Report

Primary adrenal insufficiency is a rare condition due to the impairment of adrenal glands. Previously, tuberculosis damaging adrenal glands was attributed as the main cause for it; whereas, nowadays autoimmune disease is the most common cause of it. However, rarely metastatic malignancy can cause adrenal insufficiency as well. This is a case report of a 72-year-old who presented with a three-month history of being generally unwell. Investigations showed bilateral adrenal masses with a positive short synacthen test (SST) for adrenal insufficiency. Adrenal insufficiency was managed with hydrocortisone and fludrocortisone while the biopsy showed diffuse large B-cell lymphoma (DLBCL). He underwent positron emission tomography/computed tomography (PET/CT) which showed adrenal hypermetabolic disease with retroperitoneal involvement. He was treated as stage 4 non-Hodgkin's lymphoma (NHL) with two cycles of rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy on the same admission; he was discharged home with further follow up for chemotherapy sessions. This case is unique as adrenal involvement in DBCL rarely leads to adrenal insufficiency; his symptoms resolved after receiving adrenal insufficiency treatment which further signifies the importance of its diagnosis and management.

Autoimmune paraneoplastic syndromes associated to lung cancer: A systematic review of the literature: Part 2: Hematologic, cutaneous and vascular syndromes

The development of new immune treatment in oncology and particularly for lung cancer may induce new complications, particularly activation or reactivation of auto-immune diseases. In this context, a systematic review on the auto-immune paraneoplastic syndromes associated with lung cancer appears useful. This article is the second of a series of five and deals with hematologic, cutaneous and vascular syndromes.

Adrenal Insufficiency in Metastatic Lung Cancer

We report a case of adrenal insufficiency in patient with lung cancer. Although adrenal metastases are common in cancer patients, adrenal insufficiency is a rare occurrence. Diagnosis and treatment of adrenal insufficiency will improve the physical status and the quality of life in those patients.