You are here

Article Text

Article menu
Download PDFPDF
Case Reports: Rare disease
Adrenal insufficiency due to high doses of maternal corticosteroid treatment in a premature baby
  1. Florence Blondel1,
  2. Charlotte Pierron2,
  3. Emmanuel Scalais3 and
  4. Marianne Becker4
  1. 1Pediatrics, Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg
  2. 2Neonatology and Intensive Care, Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg
  3. 3Pediatric neurology, Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg
  4. 4Pediatric endocrinology and diabetology, Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg
  1. Correspondence to Dr Marianne Becker; becker.marianne{at}chl.lu

Abstract

Adrenal insufficiency (AI) in a newborn due to hypothalamic–pituitary–adrenal (HPA) axis suppression after maternal glucocorticoid therapy during pregnancy is a rare condition. We report an AI triggered by a nosocomial infection in a premature newborn. The suspected mechanism was the suppression of the HPA axis due to high doses of maternal glucocorticoid treatment during pregnancy. AI was revealed by recurrent hypoglycaemia and mild hyponatraemia during the neonatal period. His twin brother did not develop AI, showing the variable sensitivity of adrenal suppression after exposure to the same glucocorticoid dose. The affected boy was substituted with hydrocortisone until the age of 2 years. At this age, basal morning values for cortisol and Adrenocorticotropic hormone (ACTH) had normalised. The patient also suffers from galactosaemia. We suggest screening for AI, by testing for hypoglycaemia and hyponatraemia, in newborns who were exposed to high doses of maternal methylprednisolone treatment during the pregnancy and to include galactosaemia in national neonatal screening programmes.

  • adrenal disorders
  • congenital disorders

http://dx.doi.org/10.1136/bcr-2021-246961

Statistics from Altmetric.com

    Request Permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.

    View Full Text

    Footnotes

    • Contributors MB and FB designed the work, collected and interpreted the data and drafted the initial manuscript, and reviewed and revised the manuscript. CP and ES collected and interpreted the data and critically reviewed and revised the manuscript. All the authors approved the final version of the article and aggred to be accountable for all aspects of the work.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.