A Case of Improved Adrenal Insufficiency with Corticostreoid Treatment, Secondary to Adrenal Hemorrhage.

Oh,  Hyoung Sik; Kim,  Sang Hee; Lee,  Hyung Won; Seol,  Kye Hwan; Kim,  Gil Hyun; Lee,  Hak Soo

Case Report

Journal of the Korean Society of Neonatology 2000;7(2):176-180.
Published online January 1, 2001.

A Case of Improved Adrenal Insufficiency with Corticostreoid Treatment, Secondary to Adrenal Hemorrhage.

Hyoung Sik Oh, Sang Hee Kim, Hyung Won Lee, Kye Hwan Seol, Gil Hyun Kim, Hak Soo Lee

Department of Pediatrics, Gachon Medical School, Incheon, Korea.

Abstract

The large size and vascularity of the neonatal adrenal glands are vulnerable to traumatic and asphyxial injuries. This condition varies in presentation, which the most common is an abdominal mass alone or mass with jaundice and anemia. Some infants show signs of adrenal insufficiency. Abdomial ultrasonogram is the most valuable diagnostic tool. To result in adrenal insuffiency, hemorrhage must involve both adrenals and at least 90% of the adrenocortical tissue must be destroyed. To affect infant may show signs of hypovolemic shock, electrolyte imbalance and metabolic acidosis. Treatment for adrenal insufficiency must be immediate and vigorous, and consists of intravenous glucose, fluid, and electolyte replacement. And conservative treatment failure is candidate for steroid replacement. We experienced a case of bilateral hemorrhage with adrenal insufficiency, who improved with hydrocortisone.

Key Words: Adrenal insufficiency; Adrenal hemorrhage; Hydrocortisone