• Chunxiao Liang, Taichun Qiu, Zhongyan Lu, Bing Ming, Dongmei Xie, Fei Wang, and Qing Zou.
• Department of Radiology, People's Hospital of Deyang City, Sichuan, China.
• Medicine (Baltimore). 2024 Aug 2; 103 (31): e39092e39092.

RationaleAdrenal infarction (AI) is a rare type of adrenal damage, which is relatively common in systemic lupus erythematosus, antiphospholipid antibody syndrome (APS) and pregnancy. The diagnosis of AI is mainly by computed tomography (CT) and magnetic resonance imaging, but is easily confused with other adrenal disease. Hence, this report details a condition of AI with systemic lupus erythematosus, APS and made a differential diagnosis from imaging.Patient ConcernsWe report a case of a 55-year-old woman with pain in her fossa axillaries and inguinal regions. Then CT scan disclosed bilateral adrenal diseases, and the patient was diagnosed with systemic lupus erythematosus, APS and AI after additional autoimmune examinations.DiagnosesThe patient was diagnosed as systemic lupus erythematosus with lupus nephritis, hematological damage and oromeningitis, APS, AI and secondary blood coagulation disorders.InterventionsThe patient was treated with methylprednisolone, hydroxychloroquine and low molecular heparin.OutcomesThe patient relieves and remains well 1 year after treatment.Lessons SubsectionsAI can be divided hemorrhagic and non-hemorrhagic, with bilateral lesions more common. In our case, the AI was bilateral, partially involved and non-hemorrhagic, and the "cutoff sign" was first put forward in CT, which might assist the diagnosis.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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