Adrenal haemorrhage in new born presenting as severe neonatal jaundice
DOI:
https://doi.org/10.18203/2349-3291.ijcp20230743Keywords:
Adrenal haemorrhage, Birth asphyxia, Neonate, Neonatal Jaundice, Ultrasound abdomenAbstract
Neonatal adrenal haemorrhage is a relatively uncommon. Most often associated with difficult labour, birth trauma, hypoxia, sepsis. Clinical manifestations may vary from asymptomatic to life threatening Addisonian crisis. We present a case of right subacute adrenal hematoma confirmed on MRI abdomen. Risk factor being birth asphyxia. He presented with neonatal jaundice and was managed successfully by conservative methods. Treatment depends on the clinical features and severity. Most of the cases are asymptomatic and managed conservatively. Infants with acute haemorrhage might need urgent blood transfusion. Laparotomy is indicated when haemorrhage seems to be continuing, especially when the exact site of haemorrhage is in doubt. Adrenal haemorrhage usually takes 3 weeks to 6 months to resolve completely. Our case was clinically and hemodynamically stable, so he was managed conservatively and discharged after a week. This case emphasizes the importance high degree of suspicion in evaluation of neonate presented with late onset jaundice and importance of ultrasonography in diagnosis and conservative management.
References
Yarci E, Arayici S, Sari FN, Canpolat FE, Uras N, Dilmen U. Adrenal hemorrhage presenting as a scrotal hematoma in the newborn: A case report. Arch Argent Pediatr. 2015;113:e161-3.
Mutlu M, Karaguzel G, Aslan Y, Cansu A, Okten A. Adrenal hemorrhage in newborns: a retrospective study. World J Pediatr. 2011;7:355-7.
Demirel N, Baş AY, Zenciroǧlu A. Adrenal bleeding in neonates: report of 37 cases. Turk J Pediatr. 2011;53(1):43-7.
Zessis NR, Nicholas JL, Stone SI. Severe bilateral adrenal hemorrhages in a newborn complicated by persistent adrenal insufficiency. Endocrinol Diabetes Metab Case Rep. 2018;2018:2-6.
Tuchman M, Ramnaranine ML, Woods WG, Krivit W. Three years of experience with random urinary homovanillic and vanillylmandelic acid levels in diagnosis of neuroblastoma. Pediatr. 1987;79:203-7
Katar S, Oztürkmen-Akay H, Devecioglu C, Taşkesen M. A rare cause of hyperbilirubinemia in a newborn: bilateral adrenal hematoma. Turk J Pediatr. 2008;50:485-7.
Black J, Williams DI. Natural history of adrenal haemorrhage in the newborn. Arch Dis Child. 1973;48(3):183-90.
MunganAkın İ, Tabel Y, Güngör S. Neonatal adrenal hemorrhage as a complication of traumatic vaginal delivery: diagnosis and follow-up with ultrasonography. Ann Med Res. 2008;15(2):109-11.