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May 1966

Bilateral Renal Cortical Necrosis in the Newborn: Associated With Fetomaternal Transfusion and Hypermagnesemia

Author Affiliations

From the Department of Pediatrics, University of Louisville School of Medicine, Louisville.

Am J Dis Child. 1966;111(5):541-543. doi:10.1001/archpedi.1966.02090080119011

SYMMETRICAL cortical necrosis of the kidneys has been reported occasionally in newborn infants. This entity has occurred in association with asphyxia neonatorum, erythroblastosis fetalis, septicemia, dehydration secondary to gastroenteritis, intra-uterine distress, and uteroplacental hemorrhage.1-4 The pathogenesis of the renal lesions in bilateral cortical necrosis has been attributed to renal ischemia, thrombosis of the small blood vessels being a frequently associated, but inconstant, phenomenon.1 The case report which follows is of interest in that the renal disease in this newborn infant was related to anemia resulting from an intrauterine fetomaternal transfusion. In addition, the child had hypermagnesemia, caused by the rectal instillation of magnesium sulfate (epsom salts) enemas. Because of the recent widespread publicity surrounding the use of magnesium sulfate enemas in the newborn as a dehydrating agent, primarily in the therapy of hyaline membrane disease, the potential toxicity of such therapy also will be discussed.

Report of a