The adrenal gland contains a plexus of small veins and venules which receive the secreted hormones of the adrenal gland. This venous structure appears prone to thrombosis in several hypercoagulable states. Patients with purpura fulminans may present with adrenal crisis due to thrombosis and the resultant hemorrhagic destruction of the gland. Patients with heparin- induced thrombocytopenia may rarely infarct the gland and have subsequent hemorrhage. Finally, patients with antiphospholipid antibody syndrome can have adrenal infarctions. The presentation in APLA patients is often one of adrenal insufficiency that initially may be overlooked due to nonspecific symptoms.
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