Transient adrenocortical insufficiency of prematurity (TAP, TAIP) is an uncommon condition associated with immaturity of the hypothalamic-pituitary axis in very low birthweight neonates.
Clinical features:
(1) preterm delivery, usually with very low birthweight (< 1,500 grams)
(2) hypotension unresponsive to fluid resuscitation and vasopressors
(3) hypotension responsive to cortisol therapy
(4) oliguria
(5) transient condition, with recovery within 2-3 weeks of birth
(6) exclusion of other causes of adrenal insufficiency (infection, hemorrhage, suppression secondary to maternal steroid therapy) and shock (sepsis)
The baseline serum cortisol concentration should be low (< 350 mmol/L, often < 200 mmol/L)
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