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- W4380758145 abstract "Adrenal insufficiency (AI) is a rare diagnosis. Symptoms may be vague, easily overlooked or attributed to more common childhood diagnoses. Early diagnosis and treatment is essential as untreated AI may present as adrenal crisis, a potentially fatal condition. Adrenal insufficiency may result from lesions at all levels of the hypothalamic pituitary adrenal axis. Accurate diagnosis is essential as the treatment and prognosis of AI differs according to the site and nature of the lesion. Cortisol is secreted in a circadian manner. Cortisol concentrations rise from the early hours of the morning, peak 30 minutes after waking before falling throughout the day and overnight. Childhood AI is treated with hydrocortisone, which has a short half-life, requiring three to four daily doses. Modified release formulations, which achieve a more physiological cortisol profile and require less frequent dosing, are in development and may become available to children. During periods of illness and injury, children with AI are at risk of adrenal crisis. It is essential that parents and carers are educated in the management of ‘sick days’, can recognise symptoms of adrenal crisis and seek medical advice appropriately. In turn, it is essential that medical staff know how to manage an adrenal crisis in children and young people. In this article, we will briefly review the physiology of the hypothalamic pituitary adrenal axis, causes of AI, options for treatment, methods of monitoring for the adequacy of treatment, and finally the treatment of children with AI during illness and surgery." @default.
- W4380758145 created "2023-06-16" @default.
- W4380758145 creator A5055735580 @default.
- W4380758145 date "2023-07-01" @default.
- W4380758145 modified "2023-09-29" @default.
- W4380758145 title "Diagnosis and management of children with adrenal insufficiency" @default.
- W4380758145 cites W2043046125 @default.
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- W4380758145 doi "https://doi.org/10.1016/j.paed.2023.04.001" @default.
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