[Bilateral neonatal adrenal hemorrhage associated with hypoadrenalism]

A newborn is described, who was born in term with 3250 g weight, after intrauterine hypoxia. She was born with vacuum extraction, and suffered from birth trauma and intrauterine infection. At age of one day manifested an eclampsia, which was hardly diminishable. The serum Na level was 118 mmol/l. Bilateral adrenal apoplexy was visible with ultrasound. The newborn was treated with infusion of sodium chloride and glucose, with antibiotic and glucocorticoid hormone. Her condition improved rapidly. Her serum cortisol level at 8 and 15 day after stopping of 12 days prednisolon therapy was below 2.5 micrograms/dl, marking hypadrenia. At age 3 months the function of adrenals was normal: the serum cortisol level was 11.4 micrograms/dl, and after ACTH stimulation it run up to 44.5 micrograms/dl. By screening of 1491 newborns, 13 adrenal apoplexy was found. The other 12 were one-sided and symptomless.