RT Journal Article
SR Electronic
T1 Unilateral adrenal infarction in pregnancy secondary to elevated factor VIII
JF Saudi Medical Journal
JO Saudi Med J
FD Prince Sultan Military Medical City
SP 654
OP 656
DO 10.15537/smj.2017.6.18520
VO 38
IS 6
A1 Khaled Y. Aljenaee
A1 Sulaiman A. Ali
A1 Seong K. Cheah
A1 Moudhi J. Alroomi
YR 2017
UL http://smj.org.sa/content/38/6/654.abstract
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.