Adrenal crisis in infants and young children with adrenal insufficiency: Management and prevention.
Front Endocrinol (Lausanne)
; 14: 1133376, 2023.
Article
in En
| MEDLINE
| ID: mdl-36860362
ABSTRACT
Background:
Despite the optimization of replacement therapy, adrenal crises still represent life-threatening emergencies in many children with adrenal insufficiency.Objective:
We summarized current standards of clinical practice for adrenal crisis and investigated the prevalence of suspected/incipient adrenal crisis, in relation to different treatment modalities, in a group of children with adrenal insufficiency.Results:
Fifty-one children were investigated. Forty-one patients (32 patients <4 yrs and 9 patients >4 yrs) used quartered non-diluted 10 mg tablets. Two patients <4 yrs used a micronized weighted formulation obtained from 10 mg tablets. Two patients <4 yrs used a liquid formulation. Six patients >4 yrs used crushed non-diluted 10 mg tablets. The overall number of episodes of adrenal crisis was 7.3/patient/yr in patients <4yrs and 4.9/patient/yr in patients >4 yrs. The mean number of hospital admissions was 0.5/patient/yr in children <4 yrs and 0.53/patient/yr in children >4 yrs. There was a wide variability in the individual number of events reported. Both children on therapy with a micronized weighted formulation reported no episode of suspected adrenal crisis during the 6-month observation period.Conclusion:
Parental education on oral stress dosing and switching to parenteral hydrocortisone when necessary are the essential approaches to prevent adrenal crisis in children.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Hydrocortisone
/
Adrenal Insufficiency
Type of study:
Guideline
/
Risk_factors_studies
Limits:
Child
/
Child, preschool
/
Humans
/
Infant
Language:
En
Journal:
Front Endocrinol (Lausanne)
Year:
2023
Document type:
Article
Affiliation country: