Bilateral adrenal hemorrhage and severe anemia in a neonate

Author:

Lee Christina1ORCID,Hirschman Leah1,York Teresa2,Newton Paula3

Affiliation:

1. Department of Pediatrics, University of Maryland Children’s Hospital, Baltimore, Maryland, USA

2. Department of Pediatric Hematology/Oncology, University of Maryland Children’s Hospital, Baltimore, Maryland, USA

3. Department of Pediatric Endocrinology, University of Maryland Children’s Hospital, Baltimore, Maryland, USA

Abstract

Summary Neonatal adrenal hemorrhage (NAH) occurs in up to 3% of infants and is the most common adrenal mass in newborns. The most common presentation of NAH is an asymptomatic palpable flank mass which resolves over time without intervention. In rare cases, NAH can present as hemorrhage, shock, or adrenal insufficiency. This case describes a preterm infant born with severe anemia in the setting of bilateral adrenal hemorrhages with resulting adrenal insufficiency. The infant was successfully treated with blood transfusions and steroids. This is a unique presentation of NAH as it was bilateral, presented with severe anemia, and resulted in prolonged adrenal insufficiency. Learning points Consider adrenal hemorrhage for cases of severe anemia at birth. Adrenal insufficiency is a rare complication of adrenal hemorrhage. Adrenal recovery can take months, if not years.

Publisher

Bioscientifica

Reference9 articles.

1. Neonatal adrenal hemorrhage presenting as late onset neonatal jaundice;Qureshi,2009

2. Neonatal adrenal hemorrhage: clinical and abdominal sonographic findings;Velaphi,2001

3. Severe bilateral adrenal hemorrhages in a newborn complicated by persistent adrenal insufficiency;Zessis,2018

4. Neonatal bilateral adrenal hemorrhage and adrenal insufficiency accompanied by subgaleal hematoma: a case report with brief review of literature;Esslami,2022

5. Adrenal hemorrhage in newborn: how, when and why- from case report to literature review;Toti,2019

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