Bilateral adrenal hemorrhage with signs of adrenal insufficiency in the first days of life

To the Editor, Adrenal insufficiency is often a temporary process when it is associated with adrenal hemorrhage. Many cases of adrenal hemorrhage are asymptomatic. Although rare, persistent adrenal insufficiency may occur in patients with large or bilateral adrenal hemorrhage. The large size and increased vascularity of the adrenal glands and and hypoxia-associated damaged endothelial cells can cause adrenal hemorrhage