Adrenal infarction secondary to methamphetamine use: a case report and review of the literature

Abstract

Background An acute abdomen can have a variety of causes. A commonly missed cause of abdominal pain is direct substance abuse and its sequelae. The use of methamphetamine is rising in the United States resulting in significant morbidity and mortality. There has been no reported case of methamphetamine-induced adrenal infarction based on an extensive review of available literature. Case presentation We present a case of a 34-year-old Hispanic man who presented with acute abdominal pain secondary to adrenal infarction in the setting of methamphetamine use. Left paraumbilical tenderness was present on abdominal examination. Contrast-enhanced CT of the abdomen and pelvis revealed internal hypoenhancement of the left adrenal gland, consistent with acute left adrenal infarction. The patient was managed with enoxaparin and apixaban. Conclusion Substance abuse, especially among young patients, can at times present with acute abdomen. This mandates physicians to be vigilant and take into consideration the history of substance abuse and relevant investigations. Timely diagnosis and management can prevent life-threatening complications.

Acute spontaneous non-hemorrhagic adrenal infarction with systemic lupus erythematosus and antiphospholipid antibody syndrome: A case report

“…Acute adrenal infarction (AI) is very rare and easily overlooked, especially in patients without adrenal insufficiency, which is diagnosed mainly by imaging. AI was relatively common in antiphospholipid antibody syndrome (APS), [3][4][5][6] pregnancy, [7] and also existed in Crohn disease, [8] COVID-19, [9] myelodysplastic/myeloproliferative neoplasm, [10] substance use (e.g., methamphetamine), [11] heparininduced thrombocytopenia [12] and aortic dissection, [2] etc. However a large portion of individuals originally manifested signs of AI before the primary disease was identified.…”