Unilateral Adrenal Hemorrhage Accompanied by Subgaleal Hematoma with Severe Neonatal Anemia — Case Report

Neonatal adrenal hemorrhage (NAH) occurs in up to 0.2% - 0.55 % of live birth. It is important to note that approximately 10% of these cases might have bilateral involvement. Various risk factors have been reported in addition to birth asphyxia such as sepsis, coagulation disorder, traumatic delivery, and perinatal injuries. However, in a substantial proportion of cases the etiology of bleeding cannot be established. In most cases the event is asymptomatic but in others it may be so devastating and can lead to prolonged adrenal insufficiency and severe cases to shock if not recognized early. This case describes a term infant born with severe anemia in the setting of unilateral adrenal hemorrhage and subgaleal hematoma without resulting in adrenal insufficiency. The infant was successfully treated with blood transfusions and supportive treatment. This is a unique presentation of NAH as it was unilateral associated with right subgaleal hemorrhage and presented with severe anemia.