Could factor V Leiden defect cause Addison's disease?

Abstract

Sir, We describe a case of Addison's disease caused by bilateral suprarenal haemorrhage in a patient heterozygous for factor V Leiden defect. This is the first reported case of isolated bilateral suprarenal haemorrhage in a patient with this disorder. Because of the unique blood supply of the suprarenal glands, we believe that suprarenal haemorrhage was secondary to venous infarction caused by venous thrombosis in suprarenal veins and venous plexus. A 68‐year‐old man was admitted to hospital with a 3‐week history of anorexia, lack of energy, dizziness and weight loss. There was a history of ileo‐femoral deep‐vein thrombosis in his left leg treated with anticoagulation 4 weeks previously. He was on warfarin and senna tablets. On examination, he was hypotensive and tachycardic, and his left leg was swollen. The rest of the examination was unremarkable. Sodium was low (125 mmol/l), potassium was 6.6 mmol/l and glucose 5.6 mmol/l. ECG showed right bundle branch block, and chest X‐ray …