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Diseases 2016, 4(1), 5;

Pituitary-Adrenal Axis in Prader Willi Syndrome

Developmental Endocrinology Research Group, Royal Hospital for Children, University of Glasgow, 1345 Govan Road, Glasgow G41 4TF, UK
Author to whom correspondence should be addressed.
Academic Editor: Danny Camfferman
Received: 17 December 2015 / Revised: 10 January 2016 / Accepted: 12 January 2016 / Published: 19 January 2016
(This article belongs to the Special Issue Prader-Willi Syndrome)
Full-Text   |   PDF [186 KB, uploaded 19 January 2016]


Purpose: Prader Willi syndrome (PWS) is a rare genetic condition that has concurrent endocrinological insufficiencies. The presence of growth hormone deficiency has been well documented, but adrenal insufficiency (AI) is not widely reported. A review was conducted to investigate its prevalence and relevance in PWS in both adults and children. Methodology: A literature review was performed with the search terms “Prader-Willi syndrome” and “adrenal insufficiency”. Results: The review found studies disagree on the prevalence and method of investigation of AI in PWS. Case studies demonstrate that patients with PWS are at risk of premature death, often secondary to respiratory infections. The possibility that this may be the result of the inability to mount an effective cortisol response has been studied, with some evidence confirming AI in PWS patients. Most reports agreed AI is present in PWS, however, Farholt et al. showed no HPA axis dysfunction in adults, suggesting that perhaps it is rare in adults, and children should be the focus of further studies. Conclusion: AI is present in some patients with PWS. Further research is required to ensure optimal treatment can be implemented and to prevent premature deaths related to adrenal insufficiency. Clinicians should have a low threshold for testing the adrenal axis and considering treatment for adrenal insufficiency in PWS patients. View Full-Text
Keywords: adrenal; steroid; hydrocortisone; PWS adrenal; steroid; hydrocortisone; PWS
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Edgar, O.S.; Lucas-Herald, A.K.; Shaikh, M.G. Pituitary-Adrenal Axis in Prader Willi Syndrome. Diseases 2016, 4, 5.

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