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.