Which conditions should be considered in the differential diagnoses of neonatal abstinence syndrome (NAS)?

Updated: Dec 20, 2017
  • Author: Ashraf H Hamdan, MD, MBBCh, MSc, MRCP, FAAP; Chief Editor: Santina A Zanelli, MD  more...
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Hyperviscosity and intracranial hemorrhage should also be considered. Drug withdrawal should be considered as a diagnosis in infants in whom compatible signs develop. Physicians should be aware of other potential diagnoses that should be evaluated and treated, if confirmed.

Infants with signs and symptoms of neonatal abstinence syndrome (NAS) may have other conditions that result in abnormal behavior. The nonspecific nature of the clinical features of neonatal abstinence syndrome mean that some drug-exposed infants may have exaggerated scores when they are hungry or may have other conditions such as neonatal sepsis, hypoglycemia, hypocalcemia, hyperthyroidism, or subarachnoid hemorrhage. However, congenital hypothyroidism has been reported to mask the symptoms of neonatal abstinence syndrome. For that reason, assess the infant and consider whether symptoms are solely due to neonatal abstinence syndrome and whether other investigations are warranted.

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