Am J Perinatol 2020; 37(S 02): S57-S60
DOI: 10.1055/s-0040-1713407
Original Article

Neonatal Adrenal Hemorrhage: A Case Series

Eleonora Tognato
1  Division of Pediatrics and Neonatology, Department of Maternal Medicine, Nuovo Ospedale degli Infermi, Ponderano, Biella, Italy
,
Simone Ceratto
1  Division of Pediatrics and Neonatology, Department of Maternal Medicine, Nuovo Ospedale degli Infermi, Ponderano, Biella, Italy
2  Postgraduate School of Pediatrics, University of Turin, Piazza, Polonia, Torino, Italy
,
Giorgia Enrico
1  Division of Pediatrics and Neonatology, Department of Maternal Medicine, Nuovo Ospedale degli Infermi, Ponderano, Biella, Italy
2  Postgraduate School of Pediatrics, University of Turin, Piazza, Polonia, Torino, Italy
,
Lorenzo Fiorica
1  Division of Pediatrics and Neonatology, Department of Maternal Medicine, Nuovo Ospedale degli Infermi, Ponderano, Biella, Italy
,
Roberta Spola
1  Division of Pediatrics and Neonatology, Department of Maternal Medicine, Nuovo Ospedale degli Infermi, Ponderano, Biella, Italy
,
Bruna Loperfido
1  Division of Pediatrics and Neonatology, Department of Maternal Medicine, Nuovo Ospedale degli Infermi, Ponderano, Biella, Italy
,
Lina Cimminelli
1  Division of Pediatrics and Neonatology, Department of Maternal Medicine, Nuovo Ospedale degli Infermi, Ponderano, Biella, Italy
,
Maria A. Militello
1  Division of Pediatrics and Neonatology, Department of Maternal Medicine, Nuovo Ospedale degli Infermi, Ponderano, Biella, Italy
,
Mohammad R. Eshraghy
1  Division of Pediatrics and Neonatology, Department of Maternal Medicine, Nuovo Ospedale degli Infermi, Ponderano, Biella, Italy
,
Francesco Savino
3  Dipartimento Patologia e Cura del Bambino, S.S.D, Subintesiva Allargata della Prima Infanzia, Ospedale Infantile Regina Margherita, A.U.O. Città della Salute e della Scienza, Torino, Italy
,
Francesca Giuliani
3  Dipartimento Patologia e Cura del Bambino, S.S.D, Subintesiva Allargata della Prima Infanzia, Ospedale Infantile Regina Margherita, A.U.O. Città della Salute e della Scienza, Torino, Italy
,
Anna Perona
1  Division of Pediatrics and Neonatology, Department of Maternal Medicine, Nuovo Ospedale degli Infermi, Ponderano, Biella, Italy
,
Paolo Manzoni
1  Division of Pediatrics and Neonatology, Department of Maternal Medicine, Nuovo Ospedale degli Infermi, Ponderano, Biella, Italy
› Author Affiliations

Abstract

Neonatal adrenal hemorrhage (NAH) in newborn infants is a rare event that is associated with specific anatomical and vascular characteristics. It is more common in term infants and occurs more often in neonates who feature perinatal asphyxia. Symptoms that more frequently prompt to diagnosis are prolonged jaundice, detection of an abdominal mass, anemia, scrotal discoloration and/or swelling, hypotonia, lethargy, and hypertension. However, NAH may also occur without symptoms with its detection being occasional. Imaging through ultrasound scans is the cornerstone of diagnosis and follow-up monitoring over time. Here we report on a small NAH case series comprising three full-term, macrosomic infants who were born by vaginal delivery. The first and second ones showed clear signs of birth asphyxia, whereas the third was completely asymptomatic. In all three patients, only the right adrenal gland was involved, in line with what happens in 70% of cases. NAH is usually self-limiting and prone to a progressive resolution in a time ranging between 3 weeks and 6 months and so did in our three patients.

Key Points

  • NAH is caused by perinatal asphyxia.

  • It is diagnosed with addominal ultrasound.

  • It is usually self-limiting.

Authors' Contributions

P.M., S.C., and E.T. conceived the work; P.M. supervised the case report collection, analyzed the data and revised the manuscript; E.T. and S.C. wrote the first draft of the manuscript, prepared the final version and submitted it; L.F., R.S., B.L., L.C., F.S., M.A.M., M.R.E., F.G., A.P. collected the data, followed-up with patients, reported outcomes, and gave inputs for the manuscript.




Publication History

Publication Date:
08 September 2020 (online)

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