PT - JOURNAL ARTICLE AU - Aljenaee, Khaled Y. AU - Ali, Sulaiman A. AU - Cheah, Seong K. AU - Alroomi, Moudhi J. TI - Unilateral adrenal infarction in pregnancy secondary to elevated factor VIII AID - 10.15537/smj.2017.6.18520 DP - 2017 Jun 01 TA - Saudi Medical Journal PG - 654--656 VI - 38 IP - 6 4099 - http://smj.org.sa/content/38/6/654.short 4100 - http://smj.org.sa/content/38/6/654.full SO - Saudi Med J2017 Jun 01; 38 AB - Adrenal infarction in pregnancy is an extremely rare event. We report a case of a 29-year-old pregnant woman at the twenty-fourth week of gestation that presented with an acute episode of severe localized right upper quadrant pain. Her preliminary blood investigations and abdominal ultrasonography were essentially unremarkable. A diagnosis of right adrenal infarction was subsequently established on the basis of a non-enhanced swollen right adrenal gland on CT scanning of the abdomen with contrast, consistent with the clinical presentation. She was treated with subcutaneous low molecular weight heparin (LMWH) until 2 weeks postpartum. A thrombophilia screen post-partum revealed a significantly elevated factor VIII level and a hypercoagulable state that justified prolonged anticoagulation. This case highlights the importance of a high index of suspicion for adrenal infarction in pregnancy on the clinical grounds of otherwise unexplained acute abdominal pain accompanied by suggestive radiological findings, especially in the presence of thrombophilia.