Adrenal suppression from glucocorticoids: preventing an iatrogenic cause of morbidity and mortality in children

被引：26

作者：

Ahmet, Alexandra ^{[1
,2
]}

Mokashi, Arati ^{[3
]}

Goldbloom, Ellen B. ^{[1
,2
]}

Huot, Celine ^{[4
,5
]}

Jurencak, Roman ^{[2
,6
]}

Krishnamoorthy, Preetha ^{[7
,8
]}

Rowan-Legg, Anne ^{[2
,9
]}

Kim, Harold ^{[10
]}

Pancer, Larry ^{[11
]}

Kovesi, Tom ^{[2
,12
]}

机构：

[1] Childrens Hosp Eastern Ontario, Div Endocrinol, Pediat, Ottawa, ON, Canada

[2] Univ Ottawa, Pediat, Ottawa, ON, Canada

[3] IWK Hlth Ctr, Div Endocrinol, Pediat, Halifax, NS, Canada

[4] Univ Montreal, Div Endocrinol, Pediat, Montreal, PQ, Canada

[5] CHU St Justine, Pediat, Montreal, PQ, Canada

[6] Childrens Hosp Eastern Ontario, Div Rheumatol, Pediat, Ottawa, ON, Canada

[7] Montreal Childrens Hosp, Div Endocrinol, Pediat, Montreal, PQ, Canada

[8] McGill Univ, Pediat, Montreal, PQ, Canada

[9] Childrens Hosp Eastern Ontario, Pediat, Ottawa, ON, Canada

[10] St Josephs Hosp, Div Clin Immunol & Allergy, Dept Med, London, ON, Canada

[11] Markham Stouffville Hosp, Pediat, Markham, ON, Canada

[12] Childrens Hosp Eastern Ontario, Div Respirol, Pediat, Ottawa, ON, Canada

来源：

BMJ PAEDIATRICS OPEN | 2019年 / 3卷 / 01期

关键词：

endocrinology; therapeutics;

D O I：

10.1136/bmjpo-2019-000569

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Adrenal suppression (AS) is an important side effect of glucocorticoids (GCs) including inhaled corticosteroids (ICS). AS can often be asymptomatic or associated with non-specific symptoms until a physiological stress such as an illness precipitates an adrenal crisis. Morbidity and death associated with adrenal crisis is preventable but continues to be reported in children. There is a lack of consensus about the management of children at risk of AS. However, healthcare professionals need to develop an awareness and approach to keep these children safe. In this article, current knowledge of the risk factors, diagnosis and management of AS are reviewed while drawing attention to knowledge gaps and areas of controversy. Possible strategies to reduce the morbidity associated with this iatrogenic condition are provided for healthcare professionals.

引用

页数：8

共 74 条

[1]

Adam H M, 1996, Pediatr Rev, V17, P330

[2] Frequency and Duration of Adrenal Suppression Following Glucocorticoid Therapy in Children With Rheumatic Diseases [J].