title: A case report of an extremely low birthweight infant with circulatory collapse accompanied by cerebral infarction after the acute period.
abstract: A male infant (gestational age, 26 weeks and 1 day; birthweight, 752 g) was treated for respiratory distress syndrome and thereafter required mechanical ventilation due to chronic pulmonary insufficiency. On the 34th day after birth, urine volume suddenly decreased and hypotension, oliguria, and generalized edema developed. Laboratory studies revealed rapid progression of severe hyponatremia and hyperkalemia. Although hypovolemic shock was suspected, the patient did not respond to conventional treatment of volume expansion and inotropic support. Only treatment with glucocorticoids was effective. Two weeks later, cranial ultrasonography revealed multiple, right-sided, cystic lesions that were subsequently diagnosed as cerebral infarction by magnetic resonance imaging. Several cases of extremely low birthweight infants with circulatory collapse after the acute period have been described recently, but the cause has been unclear. There has been no previous report of a case accompanied by cerebral infarction.
authors.affiliation: Department of Pediatrics, Hamamatsu University School of Medicine, 1-20-1 Handayama, Hamamatsu, Shizuoka 431-3192, Japan.
authors.forename: Shigeo
authors.initials: S
authors.lastname: Iijima
authors.forename: Takehiko
authors.initials: T
authors.lastname: Ohzeki
mesh_terms: D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D002544:Cerebral Infarction / Q000000981:diagnostic imaging / Q000453:epidemiology* / Q000503:physiopathology*; D003907:Dexamethasone / Q000627:therapeutic use; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007010:Hyponatremia / Q000209:etiology; D007231:Infant, Newborn; D019102:Infant, Very Low Birth Weight; D008279:Magnetic Resonance Imaging; D008297:Male; D012769:Shock / Q000188:drug therapy / Q000453:epidemiology*; D014463:Ultrasonography
chemical_list: D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D003907:Dexamethasone; D006854:Hydrocortisone