Premature infants are at risk for transient adrenal insufficiency.
Clinical features:
(1) very low birthweight preterm infant (often < 30 weeks)
(2) concurrent illness including respiratory distress
(3) hypotension refractory to usual interventions (fluids, inotropes)
(4) rapid improvement after administration of corticosteroids
(5) exclusion of sepsis and other causes of shock
Mechanism: immaturity of the hypothalamic-pituitary-adrenal axis with failure of the adrenal glands to produce enough cortisol
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Specialty: Pedatrics, Endocrinology
