Gastrointestinal presentation of relative adrenal insufficiency in a sick preterm neonate

Abstract

We report a sick preterm neonate with a dramatic ileus presentation mimicking necrotizing enterocolitis that promptly reversed upon hydrocortisone supplementation. Because our case illustrates a previously unsuspected clinical visage of inadequate adrenal responses in sick preterm neonates, it also emphasizes the need for improved diagnostic algorithms to identify neonates who could potentially benefit from treatment while avoiding the morbid consequences of unwarranted corticosteroids use in this population.