Amer J Perinatol 2007; 24: 493-495 DOI: 10.1055/s-2007-986694
© Thieme Medical Publishers
Gastrointestinal Presentation of Relative Adrenal Insufficiency in a Sick Preterm Neonate
Pascal M. Lavoie1, Gustavo Pelligra1, Brian Lupton1, Horacio Osiovich1
1 Division of Neonatology, Department of Pediatrics, Children's & Women's Health Centre of British Columbia, Vancouver, British Columbia, Canada

ABSTRACT

We report a sick preterm neonate with a dramatic ileus presentation mimicking necrotizing enterocolitis that promptly reversed upon hydrocortisone supplementation. Because our case illustrates a previously unsuspected clinical visage of inadequate adrenal responses in sick preterm neonates, it also emphasizes the need for improved diagnostic algorithms to identify neonates who could potentially benefit from treatment while avoiding the morbid consequences of unwarranted corticosteroids use in this population.

KEYWORDS

Infant - newborn - premature - extremely low birthweight - hydrocortisone - adrenal insufficiency - ileus - gastrointestinal motility - shock - intrauterine growth retardation - adrenocorticotropin hormone - cortisol