title: Adrenal hemorrhage in newborns: a retrospective study.
abstract: BACKGROUND
  Adrenal hemorrhage (AH) is a relatively uncommon condition in neonates. This study aimed to review the clinical, laboratory and ultrasonographic findings of AH in newborns.
  
  
  METHODS
  The medical records of 13 newborns with AH who had been admitted to our neonatal intensive care unit were retrospectively reviewed.
  
  
  RESULTS
  Of the 13 newborns with AH, 8 (62%) were term and 10 (77%) were male babies. Clinical presentations included neonatal jaundice (85%), paleness and/or flank mass (38%), discoloration of the scrotum (15%), and hypotonia/lethargy or hypotension (8%). Five newborns had anemia and four had adrenal insufficiency. Adrenal insufficiency was observed in 80% of the premature infants with AH. AH occurred on the right side in 9 patients (69%). The most predisposing cause of AH was disseminated intravascular coagulation secondary to sepsis or perinatal hypoxia in preterm infants, and large for gestational age in term infants. Ultrasonography (USG) revealed a hypoechoic mass in 7 newborns (54%), a mixed solid-liquid mass in 5 (38%), and an echogenic mass (8%) in 1. Hemorrhage disappeared within 8.6 ± 4.5 (4-16) weeks.
  
  
  CONCLUSIONS
  AH occurs in the newborns with unexplained jaundice. Adrenal insufficiency is more frequent in preterm than in mature infants. Abdominal USG is required to determine AH in a newborn with swelling and bluish discoloration of the scrotum. Serial USG is the best modality for monitoring AH to prevent unnecessary surgery.
authors.affiliation: Department of Neonatology, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey. drmehmetmutlu38@hotmail.com
authors.forename: Mehmet
authors.initials: M
authors.lastname: Mutlu
authors.forename: Gülay
authors.initials: G
authors.lastname: Karagüzel
authors.forename: Yakup
authors.initials: Y
authors.lastname: Aslan
authors.forename: Ayşegül
authors.initials: A
authors.lastname: Cansu
authors.forename: Ayşenur
authors.initials: A
authors.lastname: Okten
mesh_terms: D000307:Adrenal Gland Diseases / Q000150:complications / Q000175:diagnosis*; D000309:Adrenal Insufficiency / Q000453:epidemiology; D003937:Diagnosis, Differential; D005260:Female; D006470:Hemorrhage / Q000150:complications / Q000175:diagnosis*; D006801:Humans; D007231:Infant, Newborn; D007567:Jaundice, Neonatal / Q000209:etiology; D008297:Male; D012189:Retrospective Studies