Case ReportHyperpigmentation in a Newborn With Adrenal FailureHasan, Khalid S. MD; Zankich, Angela MD Author Information From the Pediatric Endocrinology and Diabetes Division; Phoenix Children's Hospital, Phoenix, Arizona. Reprints: Khalid S. Hasan, MD, Pediatric Endocrinology and Diabetes, Phoenix Children's Hospital, 1919 East Thomas Road, Phoenix, AZ 85016-7710. E-mail: [email protected]. The Endocrinologist 18(2):p 73-76, March 2008. | DOI: 10.1097/TEN.0b013e318169d57b Buy Metrics Abstract A premature newborn with hyperpigmentation and adrenal insufficiency due to small adrenal glands is described. The biochemical evaluation revealed salt-wasting, hypoglycemia, and a hypothalamic-pituitary-adrenal axis consistent with primary adrenal failure (elevated plasma adrenocorticotropic hormone of 1177 pg/mL with a concomitant cortisol of 10 μg/dL). An abdominal ultrasound was unable to identify adrenal glands. Hypoplastic adrenal glands in the newborn period are a rare condition especially in the absence of infectious or hemorrhagic etiology. It is likely that this infant may represent a molecular defect of adrenal development during embryonic or fetal development. © 2008 Lippincott Williams & Wilkins, Inc.