{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T12:10:43Z","timestamp":1756383043911,"version":"3.44.0"},"reference-count":27,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2022,7,23]]},"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:p>Adrenal insufficiency (AI) in a newborn due to hypothalamic\u2013pituitary\u2013adrenal (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\u2009years. 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.<\/jats:p>","DOI":"10.1136\/bcr-2021-246961","type":"journal-article","created":{"date-parts":[[2022,8,3]],"date-time":"2022-08-03T11:32:36Z","timestamp":1659526356000},"page":"e246961","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Adrenal insufficiency due to high doses of maternal corticosteroid treatment in a premature baby"],"prefix":"10.1136","volume":"15","author":[{"given":"Florence","family":"Blondel","sequence":"first","affiliation":[{"name":"Pediatrics, Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charlotte","family":"Pierron","sequence":"additional","affiliation":[{"name":"Neonatology and Intensive Care, Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emmanuel","family":"Scalais","sequence":"additional","affiliation":[{"name":"Pediatric neurology, Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1643-1935","authenticated-orcid":false,"given":"Marianne","family":"Becker","sequence":"additional","affiliation":[{"name":"Pediatric endocrinology and diabetology, Centre Hospitalier de Luxembourg, Luxembourg City, Luxembourg"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2022,8,3]]},"reference":[{"key":"2025082702303308000_15.8.e246961.1","first-page":"866","article-title":"Worldwide Exp\u00e9rience in newborn screening for classical congenital adrenal hyperplasia due to 21-hydroxylase deficiency","volume":"81","author":"Pang","year":"1998","journal-title":"Pediatrics"},{"key":"2025082702303308000_15.8.e246961.2","doi-asserted-by":"publisher","DOI":"10.1210\/er.21.3.245"},{"key":"2025082702303308000_15.8.e246961.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.arcped.2006.07.016"},{"key":"2025082702303308000_15.8.e246961.4","doi-asserted-by":"crossref","first-page":"425","DOI":"10.1016\/j.beem.2018.03.012","article-title":"Central adrenal insufficiency in children and adolescents","volume":"32","author":"Patti","year":"2018","journal-title":"Best Pract Res Clin Endocrinol Metab"},{"key":"2025082702303308000_15.8.e246961.5","doi-asserted-by":"publisher","DOI":"10.1891\/0730-0832.18.5.21"},{"key":"2025082702303308000_15.8.e246961.6","doi-asserted-by":"publisher","DOI":"10.1159\/000151652"},{"key":"2025082702303308000_15.8.e246961.7","doi-asserted-by":"crossref","first-page":"160","DOI":"10.4274\/jcrpe.v3i3.31","article-title":"Fetal adrenal suppression due to maternal corticosteroid use: case report","volume":"3","author":"Kurto\u011flu","year":"2011","journal-title":"J Clin Res Pediatr Endocrinol"},{"key":"2025082702303308000_15.8.e246961.8","doi-asserted-by":"crossref","first-page":"763","DOI":"10.1007\/s00431-009-1095-9","article-title":"Hypoglycaemic seizure and neonatal acute adrenal insufficiency after maternal exposure to prednisone during pregnancy: a case report","volume":"169","author":"Saulnier","year":"2010","journal-title":"Eur J Pediatr"},{"key":"2025082702303308000_15.8.e246961.9","doi-asserted-by":"crossref","first-page":"1279-80","DOI":"10.1001\/jama.1977.03280130061020","article-title":"Neonatal subclinical adrenal insufficiency. result of maternal steroid therapy","volume":"238","author":"Grajwer","year":"1977","journal-title":"JAMA"},{"key":"2025082702303308000_15.8.e246961.10","unstructured":"Berry G . 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