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Published on: April 7, 2023
Adrenal hemorrhage in newborns: a retrospective study
Mehmet Mutlu1, Gülay Karagüzel, Yakup Aslan
1Department of Neonatology, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey. drmehmetmutlu38@hotmail.com
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.
