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Article Synopsis
  • Adrenal infarction (AI) is a rare condition often associated with systemic lupus erythematosus, antiphospholipid antibody syndrome (APS), and pregnancy, typically diagnosed through CT and MRI imaging.
  • A case study details a 55-year-old woman with pain in specific areas, leading to a diagnosis of AI alongside systemic lupus erythematosus, APS, and secondary blood coagulation disorders.
  • The patient's treatment included medications like methylprednisolone and hydroxychloroquine, resulting in her well-being a year later; the report suggests that AI can be hemorrhagic or non-hemorrhagic, with bilateral, non-hemorrhagic cases being more common.
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To summarize the evidence on non-hemorrhagic adrenal infarction (NHAI) and identify questions arising in diagnosis and management, cases in the PubMed database were merged with our case series. A total of 92 publications were retrieved, 15 of which reported on NHAI during pregnancy. Including the four in our case series, 24 cases have been described so far.

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Article Synopsis
  • - Unilateral non-hemorrhagic adrenal infarction (NHAI) is a rare but serious condition that can cause acute abdomen during pregnancy, making diagnosis difficult due to its uncommon occurrence and varied symptoms.
  • - A case study of a 32-week pregnant woman revealed that NHAI often occurs on the right side and is frequently diagnosed over 24 hours after symptoms appear, requiring advanced imaging for a definitive diagnosis.
  • - Increased awareness and clinical suspicion of NHAI in pregnant patients are crucial for effective treatment, management, and improved outcomes for both the mother and the baby.
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A 76-year-old woman was admitted to the emergency room of Nagano Municipal Hospital with the complain of severe back pain. Chest and abdominal enhanced computed tomography scans showed bilateral adrenal infarction and minute pulmonary nodules, but she had no respiratory symptoms. After admission, a family member of the patient was found to have been in close contact with a coronavirus disease 2019 (COVID-19) patient.

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Non-Hemorrhagic Adrenal Infarction during Pregnancy: The Diagnostic Imaging Keys.

Tomography

October 2021

AP-HP, Hôpital Antoine Béclère, Service de Radiologie, 92140 Clamart, France.

non-hemorrhagic adrenal infarction (NHAI) is a rare cause of acute abdominal/flank pain during pregnancy; in order to ensure prompt and appropriate treatment, this diagnosis should not be overlooked. This case series highlights pertinent imaging findings, including ultrasounds (USs), computed tomography (CT), and magnetic resonance imaging (MRI) of recent NHAI cases. we compiled all consecutive NHAI cases from two university hospitals over a two-year period and checked the relevant clinical, laboratory, and imaging findings.

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