An early rim sign in neonatal adrenal hemorrhage

Pw, Brill; Krasna, Irwin H.; Aaron, Hillary

doi:10.2214/ajr.127.2.289

Cited by 10 publications

(3 citation statements)

References 1 publication

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“…The use of color Doppler imaging allows correct localization of the adrenal glands 16 . Moreover, as demonstrated in one of our cases (Figure 1), adrenal hematomas may display, at an early stage, a marked rim-shaped pattern of vascularization around the tumor, a sign that has already been described angiographically in neonates 24 .…”

Section: Discussionsupporting

confidence: 81%

Prenatal diagnosis of fetal adrenal masses: differentiation between hemorrhage and solid tumor by color Doppler sonography

Schwärzler

Bernard

Sénat

et al. 1999

Ultrasound in Obstet & Gyne

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We present four cases of fetal adrenal masses detected by routine prenatal ultrasound, of which three were adrenal hemorrhages and one was a fetal neuroblastoma. The differential diagnoses of fetal adrenal mass include adrenal hemorrhage, neuroblastoma, adrenal and cortical renal cysts, pulmonary sequestrations, duplication of the renoureteral system and Beckwith-Wiedemann syndrome. These can pose a diagnostic and therapeutic dilemma. A systematic comparison of the pre- and postnatal sonographic features including color Doppler imaging may help to differentiate adrenal hemorrhage from neuroblastoma prenatally.

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Section: Discussionsupporting

confidence: 81%

Prenatal diagnosis of fetal adrenal masses: differentiation between hemorrhage and solid tumor by color Doppler sonography

Schwärzler

Bernard

Sénat

et al. 1999

Ultrasound in Obstet & Gyne

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“…Ultrasonographic findings may be confirmed by intravenous urography with total body opacification effect revealing a dense vascular rim surrounding a smooth homogeneous radiolucent suprarenal mass displacing the kidney anterolaterally and inferiorly. 4 A characteristic "drooping lily" deformity of the calyces reflects the superomedial location of the mass.…”

Section: Discussionmentioning

confidence: 99%

Calcified Neonatal Adrenal Hemorrhage: Diagnostic and Therapeutic Considerations

2008

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We present the case of a premature infant in whom adrenal calcification was present at birth and postulate an etiology of in utero adrenal hemorrhage. The subject of neonatal adrenal hemorrhage is reviewed with respect to a reassessment of diagnostic and therapeutic considerations. Ultrasonography and intravenous urography confirm the diagnosis and differentiate other retroperitoneal lesions. Adrenal hemorrhage is most often a self-limited process, and medical management results in uneventful recovery of almost all patients.

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“…observed in a patient with acute myocardial infarction treated with heparin. Numerous subsequent reports implicate both heparin and warfarin [ 1, [6][7][8][9]14). The association of anticoagulant therapy with adrenal hemorrhage was first days after institution of anticoagulant therapy [ l l , 121.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis and treatment of anticoagulant‐related adrenal hemorrhage

1981

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Anticoagulant-related adrenal hemorrhage, as a cause of adrenal insufficiency, is rarely suspected and diagnosed during life. We report three patients in whom prompt diagnosis allowed successful treatment with replacement doses of corticosteroids. In all three patients, a hypotensive episode preceded the signs and symptoms of acute adrenal insufficiency. The symptoms and signs of adrenal hemorrhage were nonspecific and variable, making clinical diagnosis difficult. In none of our patients was the prothrombin time, partial thromboplastin time, or Lee White clotting time prolonged beyond the therapeutic range, and in none were excessive doses of anticoagulant therapy employed. Characteristic serum chemistry abnormalities, serum ACTH stimulation tests, and daily urinary collections for free cortisol, 17-OH ketosteroids, and 17-ketosteroids confirmed the clinical suspicion of primary adrenal insufficiency in all cases. Diagnosis was aided in one patient by abdominal computerized axial tomographic scan. In all patients, response to replacement doses of corticosteroids was prompt and gratifying, underlining the importance of suspecting this complication of anticoagulant therapy and instituting prompt lifesaving therapy. Adrenal hemorrhage is a complication of anticoagulant therapy that has been diagnosed during life in only 11 reported cases. We describe three patients in whom early diagnosis allowed prompt medical therapy and favorable outcome. The clinical presentation, diagnostic laboratory features, and therapeutic modalities are reviewed. Prolongation of prothrombin time, high levels of stress, and hypotension predispose to this complication in a patient maintained on anticoagulant therapy.

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An early rim sign in neonatal adrenal hemorrhage

Cited by 10 publications

References 1 publication

Prenatal diagnosis of fetal adrenal masses: differentiation between hemorrhage and solid tumor by color Doppler sonography

Prenatal diagnosis of fetal adrenal masses: differentiation between hemorrhage and solid tumor by color Doppler sonography

Calcified Neonatal Adrenal Hemorrhage: Diagnostic and Therapeutic Considerations

Diagnosis and treatment of anticoagulant‐related adrenal hemorrhage

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