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Vol. 13 No. 02 (2026)
International Multidisciplinary Journal for Research & Development

Articles

PATHOMORPHOLOGICAL ASPECTS OF THE INTEGRATED RELATIONSHIP BETWEEN THE ADRENAL GLAND AND THYMUS IN NEONATES WITH ADVANCED RESPIRATORY DISTRESS SYNDROME

Published 2026-02-27

  • Rustam Khatamov

Rustam Khatamov
Fergana Institute of Public Health Medicine

Abstract

Background: Respiratory distress syndrome (RDS) in newborns is a life-threatening pulmonary condition characterized by surfactant deficiency, alveolar collapse, hypoxia, and systemic stress responses. While the pulmonary features of RDS have been extensively studied, less attention has been paid to the morphofunctional integration of the adrenal gland and thymus, two central organs in neonatal stress physiology and immune regulation. Their structural alterations may play an essential role in the disease course.

Objective: This study aims to describe the histological and pathomorphological changes of the adrenal gland and thymus in neonates diagnosed with advanced respiratory distress syndrome, and to analyze the integrative relationship between these organs.

Methods: A descriptive, morphologically oriented study was conducted using adrenal and thymus specimens obtained during neonatal autopsies. Tissues were fixed in buffered formalin, embedded in paraffin, sectioned at 4–5 μm, and stained using hematoxylin–eosin, Masson’s trichrome, PAS, and immunohistochemical markers (ACTH-R, CD3, cytokeratin, Ki-67). Histological alterations were evaluated according to standard neonatal tissue morphology criteria.

Results: Advanced RDS produced marked structural alterations in both organs. The adrenal cortex demonstrated lipid depletion, cytoplasmic vacuolization, progressive cortical thinning, and focal hemorrhages, most prominent in the zona fasciculata. The adrenal medulla showed chromaffin cell swelling and reduced granularity. The thymus showed severe cortical atrophy, lymphocyte depletion, increased apoptosis, widening of medullary spaces, and prominent Hassall corpuscle degeneration. Parallel degenerative changes in both organs strongly reflected systemic stress and immune suppression.

Conclusion: Significant histopathological changes occur simultaneously in the adrenal gland and thymus during neonatal RDS, demonstrating their functional and structural interdependence. Understanding these integrative alterations provides important insights into neonatal adaptation mechanisms, immune dysfunction, and systemic stress responses in severe respiratory pathology.

Keywords

neonatal respiratory distress syndrome, adrenal gland, thymus, histology, pathomorphology, immune response, stress physiology.

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References

  1. Aleksandrova, N., & Pavlova, T. (2019). Morphological features of the adrenal glands in neonatal hypoxia. Journal of Perinatal Pathology, 12(3), 145–152.
  2. Ballabh, P. (2010). Intraventricular hemorrhage in premature infants: Mechanism of disease and prevention. Journal of Child Neurology, 25(9), 1085–1098.
  3. Barker, D. J. (2016). Developmental origins of chronic disease. Journal of Epidemiology & Community Health, 70(4), 381–382.
  4. Besnard, V., Wert, S., & Whitsett, J. (2007). Lung surfactant and neonatal respiratory distress syndrome. Pediatric Research, 62(2), 117–123.
  5. Calder, A. A., & Greer, I. A. (2020). Fetal and neonatal endocrine responses to hypoxia. Hormone Research in Pediatrics, 93(1), 1–12.
  6. Cesta, M. F. (2006). Normal structure, function and histology of the thymus. Toxicologic Pathology, 34(5), 512–524.
  7. Darnell, R., & Selman, L. (2018). Adrenal stress response in critically ill neonates. Neonatology, 113(1), 68–75.
  8. Ferrari, G., & De Sanctis, L. (2019). Neonatal adrenal physiology and pathology. Best Practice & Research Clinical Endocrinology & Metabolism, 33(2), 101–114.
  9. Hedlund, G. L., & Scott, B. B. (2014). Thymic abnormalities in pediatric patients with systemic illness. Pediatric Radiology, 44(6), 674–682.
  10. Kamitomo, M., et al. (2016). Adrenal gland morphology in neonates with perinatal asphyxia. Acta Histochemica, 118(4), 331–338.
  11. Kemp, M. W. (2014). Preterm birth, surfactant deficiency and neonatal respiratory distress. Frontiers in Immunology, 5, 575–584.
  12. Kinoshita, T., & Ishikawa, F. (2020). Pathophysiology of neonatal immune suppression and thymus atrophy. Frontiers in Pediatrics, 8, 36.
  13. Lavezzi, A. M., & Matturri, L. (2012). Histopathology of the adrenal medulla in perinatal hypoxia. International Journal of Developmental Neuroscience, 30(3), 235–240.
  14. MacGillivray, T. E. (2018). The neonatal thymus: Structure, function and clinical relevance. Journal of Pediatric Surgery, 53(2), 220–226.
  15. Sweet, D. G., et al. (2019). European Consensus Guidelines on the management of neonatal respiratory distress syndrome. Neonatology, 115(4), 432–450.

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