Bilateral adrenal infarction and secondary haemorrhage in pregnancy: implications of factor V Leiden heterozygosity. A review of the literature and a case report
Adrenal haemorrhage in pregnancy is rare but can lead to significant maternal and fetal morbidity if unrecognised. We present the case of a 25-year-old woman in her second pregnancy, who was admitted at 34 + 4 weeks of gestation with severe abdominal pain. Despite initial unremarkable assessments, f...
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| Language: | English |
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Elsevier
2025-03-01
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| Series: | Clinical Medicine |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1470211825000065 |
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| author | Wiaam Elradi Samreen Innayat Ahmed Hanafy Sharifah Naseem Abuzar Awadelkareem Deepika Meneni |
| author_facet | Wiaam Elradi Samreen Innayat Ahmed Hanafy Sharifah Naseem Abuzar Awadelkareem Deepika Meneni |
| author_sort | Wiaam Elradi |
| collection | DOAJ |
| description | Adrenal haemorrhage in pregnancy is rare but can lead to significant maternal and fetal morbidity if unrecognised. We present the case of a 25-year-old woman in her second pregnancy, who was admitted at 34 + 4 weeks of gestation with severe abdominal pain. Despite initial unremarkable assessments, further imaging revealed a left adrenal haemorrhage, with evidence of prior right adrenal infarction, resulting in primary adrenal insufficiency. Haematological investigations later confirmed heterozygous factor V Leiden as a likely contributing factor. This report underscores the diagnostic challenges of adrenal pathology in pregnancy, where symptoms may overlap with more common conditions. Immediate management with hydrocortisone therapy, supported by a multidisciplinary team (MDT), was employed, with a successful outcome for both mother and child following delivery by caesarean section. |
| format | Article |
| id | doaj-art-51f51fe603274bb883b901b095798b09 |
| institution | Kabale University |
| issn | 1470-2118 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical Medicine |
| spelling | doaj-art-51f51fe603274bb883b901b095798b092025-02-07T04:47:18ZengElsevierClinical Medicine1470-21182025-03-01252100288Bilateral adrenal infarction and secondary haemorrhage in pregnancy: implications of factor V Leiden heterozygosity. A review of the literature and a case reportWiaam Elradi0Samreen Innayat1Ahmed Hanafy2Sharifah Naseem3Abuzar Awadelkareem4Deepika Meneni5Obstetrics and Gynaecology Department, The James Cook University Hospital, South Tees NHS Foundation Trust, Middlesbrough, United Kingdom; Corresponding author.Obstetrics and Gynaecology Department, The James Cook University Hospital, South Tees NHS Foundation Trust, Middlesbrough, United KingdomEndocrinology Department, The James Cook University Hospital, South Tees NHS Foundation Trust, Middlesbrough, United KingdomObstetrics and Gynaecology Department, The James Cook University Hospital, South Tees NHS Foundation Trust, Middlesbrough, United KingdomEndocrinology Department, The James Cook University Hospital, South Tees NHS Foundation Trust, Middlesbrough, United KingdomObstetrics and Gynaecology Department, The James Cook University Hospital, South Tees NHS Foundation Trust, Middlesbrough, United KingdomAdrenal haemorrhage in pregnancy is rare but can lead to significant maternal and fetal morbidity if unrecognised. We present the case of a 25-year-old woman in her second pregnancy, who was admitted at 34 + 4 weeks of gestation with severe abdominal pain. Despite initial unremarkable assessments, further imaging revealed a left adrenal haemorrhage, with evidence of prior right adrenal infarction, resulting in primary adrenal insufficiency. Haematological investigations later confirmed heterozygous factor V Leiden as a likely contributing factor. This report underscores the diagnostic challenges of adrenal pathology in pregnancy, where symptoms may overlap with more common conditions. Immediate management with hydrocortisone therapy, supported by a multidisciplinary team (MDT), was employed, with a successful outcome for both mother and child following delivery by caesarean section.http://www.sciencedirect.com/science/article/pii/S1470211825000065Adrenal haemorrhageAdrenal insufficiencyPregnancyAcute abdomenComputed tomographyFactor V Leiden |
| spellingShingle | Wiaam Elradi Samreen Innayat Ahmed Hanafy Sharifah Naseem Abuzar Awadelkareem Deepika Meneni Bilateral adrenal infarction and secondary haemorrhage in pregnancy: implications of factor V Leiden heterozygosity. A review of the literature and a case report Clinical Medicine Adrenal haemorrhage Adrenal insufficiency Pregnancy Acute abdomen Computed tomography Factor V Leiden |
| title | Bilateral adrenal infarction and secondary haemorrhage in pregnancy: implications of factor V Leiden heterozygosity. A review of the literature and a case report |
| title_full | Bilateral adrenal infarction and secondary haemorrhage in pregnancy: implications of factor V Leiden heterozygosity. A review of the literature and a case report |
| title_fullStr | Bilateral adrenal infarction and secondary haemorrhage in pregnancy: implications of factor V Leiden heterozygosity. A review of the literature and a case report |
| title_full_unstemmed | Bilateral adrenal infarction and secondary haemorrhage in pregnancy: implications of factor V Leiden heterozygosity. A review of the literature and a case report |
| title_short | Bilateral adrenal infarction and secondary haemorrhage in pregnancy: implications of factor V Leiden heterozygosity. A review of the literature and a case report |
| title_sort | bilateral adrenal infarction and secondary haemorrhage in pregnancy implications of factor v leiden heterozygosity a review of the literature and a case report |
| topic | Adrenal haemorrhage Adrenal insufficiency Pregnancy Acute abdomen Computed tomography Factor V Leiden |
| url | http://www.sciencedirect.com/science/article/pii/S1470211825000065 |
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