Lee Christina, Hirschman Leah, York Teresa, Newton Paula
Department of Pediatrics, University of Maryland Children's Hospital, Baltimore, Maryland, USA.
Department of Pediatric Hematology/Oncology, University of Maryland Children's Hospital, Baltimore, Maryland, USA.
Endocrinol Diabetes Metab Case Rep. 2024 Mar 13;2024(1). doi: 10.1530/EDM-23-0091. Print 2024 Jan 1.
Neonatal adrenal hemorrhage (NAH) occurs in up to 3% of infants and is the most common adrenal mass in newborns. The most common presentation of NAH is an asymptomatic palpable flank mass which resolves over time without intervention. In rare cases, NAH can present as hemorrhage, shock, or adrenal insufficiency. This case describes a preterm infant born with severe anemia in the setting of bilateral adrenal hemorrhages with resulting adrenal insufficiency. The infant was successfully treated with blood transfusions and steroids. This is a unique presentation of NAH as it was bilateral, presented with severe anemia, and resulted in prolonged adrenal insufficiency.
Consider adrenal hemorrhage for cases of severe anemia at birth. Adrenal insufficiency is a rare complication of adrenal hemorrhage. Adrenal recovery can take months, if not years.
新生儿肾上腺出血（NAH）在高达3%的婴儿中发生，是新生儿中最常见的肾上腺肿块。NAH最常见的表现是无症状的可触及侧腹肿块，无需干预即可随时间消退。在罕见情况下，NAH可表现为出血、休克或肾上腺功能不全。本病例描述了一名早产婴儿，出生时患有严重贫血，伴有双侧肾上腺出血，导致肾上腺功能不全。该婴儿通过输血和类固醇成功治疗。这是NAH的一种独特表现，因为它是双侧的，伴有严重贫血，并导致长期肾上腺功能不全。
对于出生时严重贫血的病例，应考虑肾上腺出血。肾上腺功能不全是肾上腺出血的罕见并发症。肾上腺恢复可能需要数月甚至数年时间。
