EC Clinical and Medical Case Reports

A white non-pregnant female in her late 20s presented with a few hour history of new onset left sided abdominal pain, nausea and vomiting to the emergency department. On examination, she was haemodynamically stable and her abdomen was soft, with tenderness and guarding in the epigastrium, left upper quadrant and left flank. Initial investigations revealed an elevated white cell count and lactate, and mildly elevated C-reactive protein. Initial CT imaging revealed adrenal pathology, which was confirmed to be unilateral non-haemorrhagic acute left sided adrenal infarction through further CT and MRI scans. Antithrombin III deficiency was identified to be the precipitating cause, and thus the patient was started on lifelong warfarin. To our knowledge there is no literature describing unilateral non-haemorrhagic adrenal infarction (NHAI) in a non- pregnant female, or NHAI secondary to antithrombin III deficiency was found, making this case unique in its presentation.

 Keywords: Antithrombin III Deficiency; Non-Haemorrhagic Adrenal Infarction (NHAI); Non-Pregnant Female

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