Unilateral adrenal infarction in pregnancy secondary to elevated factor VIII

Aljenaee, Khaled; Ali, Sulaiman A; Cheah, Seong K; Alroomi, Moudhi J

doi:10.15537/smj.2017.6.18520

Cited by 12 publications

(13 citation statements)

References 10 publications

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“…Nonhemorrhagic adrenal infarction (NHAI) is a very rare diagnosis with only a few reported cases during pregnancy [1][2][3][4][5][6][7][8][9][10][11]. We have found around nine cases in the literature describing unilateral NHAI during pregnancy [ Adrenal infarction can present with abdominal pain, nausea and vomiting as well as electrolytes disturbances.…”

Section: Discussionmentioning

confidence: 99%

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Left Flank Pain During Pregnancy With an Unpredictable Etiology: Think of Nonhemorrhagic Adrenal Infarction

et al. 2021

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Abdominal pain is the most presenting complaint during pregnancy with multiple etiologies. The diagnosis could be unpredictable. We present a case of 36-year-old pregnant woman gravida 10 para 7 abortus 2 at 36 + 5 weeks of gestation presenting twice for an increasing left abdominal pain, not relieved despite analgesics. She was delivered for severe oligohydramnios. After delivery, she was found to have a left adrenal infarction on computed tomography scan. She was found to have two mutations of the gene MTHFR 677CC. Our presented case should remind physicians to consider the presence of thromboembolic state during pregnancy. The diagnosis of adrenal infarction should be among the differentials of an ambiguous flank pain that is resilient to medical therapy. Diagnosis in a pregnant patient can be easily confirmed with MRI, after which anticoagulation should be started and the workup for hypercoagulable state investigated.

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Section: Discussionmentioning

confidence: 99%

“…In two cases of Green et al and Sormunen-Harju et al [ 1 , 5 ], both patients had significant results of heterozygous MTHFR C677T polymorphism gene mutation whereas another one [ 13 ] was associated with antiphospholipid syndrome. Another case was associated with factor VIII [ 2 ].…”

Section: Discussionmentioning

confidence: 99%

Left Flank Pain During Pregnancy With an Unpredictable Etiology: Think of Nonhemorrhagic Adrenal Infarction

et al. 2021

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“…Adrenal gland infarction is usually haemorrhagic and bilateral 1. Unilateral adrenal gland infarction in pregnancy is extremely rare, with eight cases reported in medical literature to date 2–6. Most of these infarcts were associated with an underlying thrombophilic syndrome, like antiphospholipid syndrome, Factor VIII abnormality4 or methylenetetrahydrofolatereductase gene mutation 2…”

Section: Introductionmentioning

confidence: 99%

Cryptogenic adrenal infarction: a rare case of unilateral adrenal infarction in a pregnant woman

Agarwal¹,

Soe

2019

BMJ Case Rep

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Adrenal infarction is a rare event, especially in pregnancy. The diagnosis is challenging because patients present with acute abdomen and initial workup are usually unrevealing. We present a case of unilateral adrenal infarction in a pregnant young woman without any other causes of thrombophilia, who presented with acute abdominal pain and an unremarkable initial workup. MRI and contrast-enhanced CT scan revealed a non-haemorrhagic infarct of the right adrenal gland. Our case highlights the importance of considering this rare diagnosis in the differential for a pregnant woman with acute abdomen without any obvious surgical cause.

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“…In most case reports we were able to find, patients were started on anticoagulation, which was continued for a brief period postpartum. The majority of cases reported unilateral adrenal infarct with no evidence of adrenal insufficiency [5][6]. Unilateral adrenal infarct is a rare finding in pregnancy, but an important diagnosis to consider to prevent incorrect management and worsening bilateral infarction.…”

Section: Discussionmentioning

confidence: 99%

Non-hemorrhagic unilateral adrenal infarct in pregnancy

Fei¹,

Buschur²

2019

ijcriog

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Introduction: Adrenal infarct is a rare cause of abdominal pain, which is especially true in pregnancy. The symptoms and signs of insufficiency will depend on the amount of adrenal function lost. The adrenal gland has a unique vasculature that may facilitate infarction in a hypercoagulable state. Currently only limited case reports and small series describing evaluation and management of adrenal infarct are found in the literature. Unilateral adrenal infarct is a rare finding in pregnancy but an important diagnosis to consider to prevent incorrect management and worsening bilateral infarction. Case Report: A 21-year-old G2P0010 presented at 29 4/7 weeks with sudden onset right upper quadrant and flank pain, fever, nausea, and vomiting. The patient was initially empirically treated for complicated urinary tract infection/pyelonephritis despite no clear laboratory evidence of infection. There was no evidence of adrenal insufficiency with the exception of fasting ketosis. The remainder of evaluation was unremarkable including ultrasounds and X-rays. Unilateral adrenal infarct was diagnosed on contrast-enhanced computed tomography with no associated hemorrhage.Thrombophilia assessment was notable for methylenetetrahydrofolate reductase (MTHFR) gene heterozygous and prothrombin G20210A gene heterozygous. She

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Unilateral adrenal infarction in pregnancy secondary to elevated factor VIII

Cited by 12 publications

References 10 publications

Left Flank Pain During Pregnancy With an Unpredictable Etiology: Think of Nonhemorrhagic Adrenal Infarction

Left Flank Pain During Pregnancy With an Unpredictable Etiology: Think of Nonhemorrhagic Adrenal Infarction

Cryptogenic adrenal infarction: a rare case of unilateral adrenal infarction in a pregnant woman

Non-hemorrhagic unilateral adrenal infarct in pregnancy

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