[Acute adrenal hemorrhage in newborn infants: the importance of early diagnosis (author's transl)]

Abstract

Two case reports demonstrate the importance of an early diagnosis for the therapy of adrenal hemorrhage. In the first case with unilateral hemorrhage, the hemorrhage as such was of importance. In the second case with bilateral hemorrhage, the course was dominated by acute adrenal insufficiency with circulatory collapse and major salt loss. The diagnosis was supported by the typical changes in electrolyte levels as well as by radiography, and endocrinological results. With early therapy (in the first instance by surgery, and in the latter by substitution of corticosteroids), both children safely passed the critical period. In the second child ACTH administration did not, in the first phase of the disease, result in a significant rise of plasma cortisol. However, two months later there was a normal rise of the cortisol level following ACTH administration. From this observation we conclude that a favourable regeneration of the adrenal glands has resulted.