Skip to main content
SpringerLink
Log in

Adrenal hemorrhage in newborns: a retrospective study

  • Brief Report
  • Published:
World Journal of Pediatrics Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Bergami G, Malena S, Di Mario M, Fariello G. Echography in the follow-up of neonatal AH. The presentation of 14 cases. Radiol Med 1990;79:474–478.

    PubMed  CAS  Google Scholar 

  2. Lee MC, Lin LH. Ultrasound screening of neonatal adrenal hemorrhage. Acta Paediatr Taiwan 2000;41:327–330.

    PubMed  CAS  Google Scholar 

  3. Velaphi SC, Perlman JM. Neonatal adrenal hemorrhage: clinical and abdominal sonographic findings. Clin Pediatr (Phila) 2001;40:545–548.

    Article  CAS  Google Scholar 

  4. Katar S, Oztürkmen-Akay H, DevecioĞlu C, Taşkesen M. A rare cause of hyperbilirubinemia in a newborn: bilateral adrenal hematoma. Turk J Pediatr 2008;50:485–487.

    PubMed  Google Scholar 

  5. Miele V, Galluzzo M, Patti G, Mazzoni G, Calisti A, Valenti M. Scrotal hematoma due to neonatal adrenal hemorrhage: the value of ultrasonography in avoiding unnecessary surgery. Pediatr Radiol 1997;27:672–674.

    Article  PubMed  CAS  Google Scholar 

  6. Duman N, Oren H, Gülcan H, Kumral A, Olguner M, Ozkan H. Scrotal hematoma due to neonatal adrenal hemorrhage. Pediatr Int 2004;46:360–362.

    Article  PubMed  Google Scholar 

  7. Rumińska M, Welc-Dobies J, Lange M, Maciejewska J, Pyrzak B, Brzewski M. Adrenal hemorrhage in neonates: risk factors and diagnostic and clinical procedure. Med Wieku Rozwoj 2008;12:457–462.

    PubMed  Google Scholar 

  8. Chang TA, Chen CH, Liao MF, Chen CH. Asymptomatic neonatal adrenal hemorrhage. Clin Neonatol 1998;5:23–26.

    Google Scholar 

  9. Black J, Williams DI. Natural history of adrenal haemorrhage in the newborn. Arch Dis Child 1973;48:183–190.

    Article  PubMed  CAS  Google Scholar 

  10. Chen CH, Chang TA. The value of ultrasound in the diagnosis and management of neonatal adrenal hemorrhage. Chin J Radiol 1999;24:107–111.

    Google Scholar 

  11. Huang CY, Lee YJ, Lee HC, Huang FY. Picture of the month. Neonatal adrenal hemorrhage. Arch Pediatr Adolesc Med 2000;154:417–418.

    PubMed  CAS  Google Scholar 

  12. Watterberg KL. Adrenal insufficiency and cardiac dysfunction in the preterm infant. Pediatr Res 2002;51:422–424.

    Article  PubMed  CAS  Google Scholar 

  13. Wang CH, Chen SJ, Yang LY, Tang RB. Neonatal adrenal hemorrhage presenting as a multiloculated cystic mass. J Chin Med Assoc 2008;71:481–484.

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Neonatology, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey

    Mehmet Mutlu & Yakup Aslan

  2. Department of Pediatric Endocrinology, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey

    Gülay Karagüzel & Ayşenur Ökten

  3. Department of Radiology, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey

    Ayşegül Cansu

  4. Department of Pediatrics, Karadeniz Technical University, Faculty of Medicine, Trabzon, Turkey

    Mehmet Mutlu

Authors
  1. Mehmet Mutlu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Gülay Karagüzel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yakup Aslan
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ayşegül Cansu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ayşenur Ökten
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mehmet Mutlu.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Mutlu, M., Karagüzel, G., Aslan, Y. et al. Adrenal hemorrhage in newborns: a retrospective study. World J Pediatr 7, 355–357 (2011). https://doi.org/10.1007/s12519-011-0259-7

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12519-011-0259-7

Key words

Search

Navigation