An Uncommon Cause of Neonatal Hypertension

Adrenal hematoma is a very rare acquired cause of neonatal hypertension. In this study, we report a case of neonatal hypertension associated with adrenal hematoma. A male neonate was immediately transferred to our neonatal intensive care unit after delivery due to meconium aspiration. He needed to be on mechanical ventilation support. During his hospital stay, hospital records showed normal blood pressure. However, 15 days after discharge, he was diagnosed with hypertension and was admitted to our Nephrology Division. Except for irritability, physical examination was normal. Blood pressure was normal, while right renal agenesis, grade two dilatation in the collective system of the left kidney, a round heterogeneous cyst (measuring 46×28 mm), and adrenal hematoma with no blood flow in the left suprarenal region were detected by ultrasound. Renal scintigraphy showed right renal agenesis, prolonged retention of the injected material in the left kidney, and a mass on the left kidney. Antihypertensive therapy was initiated for the neonate and the adrenal hematoma was checked weekly. The mass gradually shrank and his blood pressure readings returned to normal for his age.
Neonates with hypertension and history of birth complications should be evaluated for adrenal hematoma to determine the reasons for hypertension.