Adrenal haemorrhage with cholestasis and adrenal crisis in a newborn of a diabetic mother.
The large hyperaemic foetal adrenal gland is vulnerable to vascular damage. This may occur in the neonatal period as a consequence of difficult labour, or its aetiology may not be apparent. The spectrum of presentation is considerable, ranging from asymptomatic to severe life-threatening intra-abdominal haemorrhage. The presentation of adrenal insufficiency may be delayed but the regenerative capacity of the adrenal is great, and most adrenal haemorrhage is not associated with significantly impaired function. Some reports showed that cholestatic hepatopathy with congenital hypopituitarism reversed by hydrocortisone treatment is considered in the context of the endocrine syndrome, probably as a consequence of the adrenal failure. We describe a case of bilateral adrenal haemorrhage with hepatitis syndrome and persistent hypoglycaemia in a newborn male with striking features of neonatal cholestasis and adrenal crisis.
Koklu
Esad
E
Department of Paediatrics, Division of Neonatology and Paediatric Endocrinology and Metabolism, School of Medicine, Erciyes University, Kayseri, Turkey. esad@erciyes.edu.tr
Kurtoglu
Selim
S
Akcakus
Mustafa
M
Koklu
Selmin
S
D000311:Adrenal Glands / Q000098:blood supply / Q000000981:diagnostic imaging; D000309:Adrenal Insufficiency / Q000150:complications* / Q000000981:diagnostic imaging; D000328:Adult; D002779:Cholestasis / Q000150:complications*; D005260:Female; D006470:Hemorrhage / Q000150:complications*; D006505:Hepatitis / Q000150:complications; D006801:Humans; D007003:Hypoglycemia / Q000150:complications; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D011254:Pregnancy in Diabetics; D016216:Ultrasonography, Prenatal