tetano
Editor, Senior Moderator
Cureus
. 2021 Nov 29;13(11):e20007.
doi: 10.7759/cureus.20007. eCollection 2021 Nov.
Bilateral Neonatal Adrenal Hemorrhage Associated With Severe Maternal COVID-19 Infection
Marcio José Concepción-Zavaleta[SUP] 1 [/SUP], Sofia Pilar Ildefonso-Najarro[SUP] 2 [/SUP], Esteban Plasencia-Dueñas[SUP] 2 [/SUP], Julia Cristina Coronado Arroyo[SUP] 3 [/SUP], Francisca Elena Zavaleta-Gutiérrez[SUP] 4 [/SUP], Luis Concepción-Urteaga[SUP] 5 [/SUP], Frederick Massucco Revoredo[SUP] 6 [/SUP], Anthony Ramos-Yataco[SUP] 7 [/SUP], Kelly Meza[SUP] 8 [/SUP]
Affiliations
Abstract
Adrenal hemorrhage is the most common cause of adrenal mass in newborns. We present a case of a full-term male, born by cesarean section due to acute fetal distress from a mother with severe coronavirus disease 2019 (COVID-19) infection. He was diagnosed with hypoxic-ischemic encephalopathy, multifactorial shock, and early neonatal sepsis. On the seventh day of hospitalization, hemoglobin dropped and thus blood transfusion was required, and abdominal ultrasound showed bilateral adrenal hemorrhage. He developed relative adrenal insufficiency without either hemodynamic instability or electrolyte imbalances. The use of parenteral corticosteroids was not required. Follow-up ultrasonography and adrenal axis laboratory examination revealed complete resolution of adrenal hemorrhage. Neonatal adrenal hemorrhage has a wide variety of clinical manifestations. Ultrasound is preferred for both initial screening and follow-up evaluation. Adrenal insufficiency occurs rarely in neonatal adrenal hemorrhage. Treatment is usually conservative. We emphasize the importance of a timely diagnosis and clinical follow-up of adrenal hemorrhage in neonates with fetal distress born from mothers with severe COVID-19.
Keywords: adrenal glands; adrenal haemorrhage; covid-19 outbreak; fetal distress; new-born.
. 2021 Nov 29;13(11):e20007.
doi: 10.7759/cureus.20007. eCollection 2021 Nov.
Bilateral Neonatal Adrenal Hemorrhage Associated With Severe Maternal COVID-19 Infection
Marcio José Concepción-Zavaleta[SUP] 1 [/SUP], Sofia Pilar Ildefonso-Najarro[SUP] 2 [/SUP], Esteban Plasencia-Dueñas[SUP] 2 [/SUP], Julia Cristina Coronado Arroyo[SUP] 3 [/SUP], Francisca Elena Zavaleta-Gutiérrez[SUP] 4 [/SUP], Luis Concepción-Urteaga[SUP] 5 [/SUP], Frederick Massucco Revoredo[SUP] 6 [/SUP], Anthony Ramos-Yataco[SUP] 7 [/SUP], Kelly Meza[SUP] 8 [/SUP]
Affiliations
- PMID: 34987898
- PMCID: PMC8716005
- DOI: 10.7759/cureus.20007
Abstract
Adrenal hemorrhage is the most common cause of adrenal mass in newborns. We present a case of a full-term male, born by cesarean section due to acute fetal distress from a mother with severe coronavirus disease 2019 (COVID-19) infection. He was diagnosed with hypoxic-ischemic encephalopathy, multifactorial shock, and early neonatal sepsis. On the seventh day of hospitalization, hemoglobin dropped and thus blood transfusion was required, and abdominal ultrasound showed bilateral adrenal hemorrhage. He developed relative adrenal insufficiency without either hemodynamic instability or electrolyte imbalances. The use of parenteral corticosteroids was not required. Follow-up ultrasonography and adrenal axis laboratory examination revealed complete resolution of adrenal hemorrhage. Neonatal adrenal hemorrhage has a wide variety of clinical manifestations. Ultrasound is preferred for both initial screening and follow-up evaluation. Adrenal insufficiency occurs rarely in neonatal adrenal hemorrhage. Treatment is usually conservative. We emphasize the importance of a timely diagnosis and clinical follow-up of adrenal hemorrhage in neonates with fetal distress born from mothers with severe COVID-19.
Keywords: adrenal glands; adrenal haemorrhage; covid-19 outbreak; fetal distress; new-born.