Steroid-Induced Iatrogenic Adrenal Insufficiency in Children: A Literature Review
Division of Endocrinology and Metabolism, Tokyo Metropolitan Children’s Medical Center, 2-8-29 Musashidai, Fuchu, Tokyo 183-8561, Japan
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Endocrines 2020, 1(2), 125-137; https://doi.org/10.3390/endocrines1020012
Received: 12 October 2020 / Revised: 3 December 2020 / Accepted: 5 December 2020 / Published: 9 December 2020
The present review focuses on steroid-induced adrenal insufficiency (SIAI) in children and discusses the latest findings by surveying recent studies. SIAI is a condition involving adrenocorticotropic hormone (ACTH) and cortisol suppression due to high doses or prolonged administration of glucocorticoids. While its chronic symptoms, such as fatigue and loss of appetite, are nonspecific, exposure to physical stressors, such as infection and surgery, increases the risk of adrenal crisis development accompanied by hypoglycemia, hypotension, or shock. The low-dose ACTH stimulation test is generally used for diagnosis, and the early morning serum cortisol level has also been shown to be useful in screening for the condition. Medical management includes gradually reducing the amount of steroid treatment, continuing administration of hydrocortisone corresponding to the physiological range, and increasing the dosage when physical stressors are present.
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Keywords:
adrenal insufficiency; children; endocrinology; glucocorticoids; hypothalamic–pituitary–adrenal axis; therapeutics
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MDPI and ACS Style
Akahoshi, S.; Hasegawa, Y. Steroid-Induced Iatrogenic Adrenal Insufficiency in Children: A Literature Review. Endocrines 2020, 1, 125-137. https://doi.org/10.3390/endocrines1020012
AMA Style
Akahoshi S, Hasegawa Y. Steroid-Induced Iatrogenic Adrenal Insufficiency in Children: A Literature Review. Endocrines. 2020; 1(2):125-137. https://doi.org/10.3390/endocrines1020012
Chicago/Turabian StyleAkahoshi, Shogo; Hasegawa, Yukihiro. 2020. "Steroid-Induced Iatrogenic Adrenal Insufficiency in Children: A Literature Review" Endocrines 1, no. 2: 125-137. https://doi.org/10.3390/endocrines1020012
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