Neonatal Adrenal Insufficiency Associated With Maternal Cushing's Syndrome

A female infant was delivered prematurely to a patient with Cushing's syndrome due to adrenal adenoma. At 20 hours of life the infant developed vascular collapse, hyponatremia, and hyperkalemia. These features of adrenal insufficiency responded promptly to the administration of hydrocortisone and saline. At 7 weeks, responsiveness of the infant's adrenal cortices to exogenous ACTH was demonstrated. Steroid replacement was subsequently discontinued and the infant has remained well. Attention is drawn to the unusually high prevalence of adrenal adenoma and carcinoma among the reported cases of pregnancy during Cushing's syndrome.