Abstract
A newborn girl presented with symptoms of severe early onset sepsis but also with systemic hypertension (SH) at age 3 h. Plasma catecholamine (CAT) levels were extremely elevated, reflecting increased release of CAT from a congenital neuroblastoma (NB). Clinical symptoms at time of admission were: prolonged capillary refill (5 s), tachycardia, tachydyspnoea, metabolic acidosis (pH 7.17, lactate 11.8 mmol/l), fever (38.4 °C) and SH: 90/50/65 mmHg (systolic/diastolic/mean). The infant experienced organ failure (lung, heart, liver). A retroperitoneal dumbbell tumour was detected. Plasma CAT levels at age 15 h were: noradrenaline 219 nmol/l; adrenaline 13 nmol/l; and dopamine 65.3 nmol/l. SH responded to intermittent α-adrenergic blockage. CAT-related symptoms ceased within 1 week. The intraspinal NB was surgically removed when cord compression became symptomatic. The neurological and developmental state is normal at age 17 months. The abdominal NB regressed spontaneously.
Conclusion A neuroblastoma should be considered in newborn infants presenting with a shock-like condition together with systemic hypertension.
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Received: 1 January 2001 and in revised form: 19 March 2001 / Accepted: 19 March 2001
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Lindner, W., Behnisch, W., Kunz, U. et al. Congenital neuroblastoma mimicking early onset sepsis. Eur J Pediatr 160, 436–438 (2001). https://doi.org/10.1007/s004310100772
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DOI: https://doi.org/10.1007/s004310100772