Hypopituitarism in a preterm infant with history of congenital syphilis and intraventricular hemorrhage

Abstract

A baby girl was born at 29 weeks and 2 days gestation with a physical examination notable for petechial rash, hepatosplenomegaly, and hydrops. The baby was born before the mother could be rescreened for syphilis and non-treponemal tests were positive at birth. The first weeks of life were complicated by clinical instability and post-hemorrhagic hydrocephalus that probably resulted from a combination of prematurity and syphilis. During the 2nd month of life, she showed a failure to thrive, persistent hypoglycemia, and diabetes insipidus and was diagnosed with hypopituitarism. Hormonal substitution treatment was challenging and required multiple adjustments until satisfactory control was attained.