Bilateral adrenal infarction in a patient with essential thrombocythemia: a case report and brief literature review

Adrenal infarction (AI) is rare condition caused by inadequate blood supply to the adrenal glands, with few reports of its association with essential thrombocythemia (ET). Here, we report a case of bilateral AI as an initial thrombotic complication in a patient with ET. A 69-year-old man presented with right abdominal pain. Abdominal computed tomography (CT) showed diffuse enlargement and poor enhancement of bilateral adrenal glands. He was diagnosed with bilateral AI. Based on positive screening for thrombocytosis and the Janus kinase 2 V617F mutation, he was diagnosed with ET. After low-dose aspirin therapy, he showed no symptom recurrence. The cortisol response in the adrenocorticotropic hormone stimulation test decreased at onset but improved after three months. Furthermore, abdominal CT revealed improvement in bilateral adrenal enlargement and enhancement. In patients presenting with AI, ET should be considered as a potential underlying disease, and early diagnosis and treatment is important to prevent recurrence.