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Emergency and perioperative management of adrenal insufficiency in children and young people: British Society for Paediatric Endocrinology and Diabetes consensus guidance

Adrenal insufficiency (AI) is characterised by lack of cortisol production from the adrenal glands. This can be a primary adrenal disorder or secondary to adrenocorticotropic hormone deficiency or suppression from exogenous glucocorticoids. Symptoms of AI in children may initially be non-specific an...

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Autores principales: Mushtaq, Talat, Ali, Salma R, Boulos, Nabil, Boyle, Roisin, Cheetham, Tim, Davies, Justin Huw, Elder, Charlotte Jane, Gan, Hoong-Wei, Hindmarsh, Peter C, Katugampola, Harshini, Krone, Nils, Salomon Estebanez, Maria, Shenoy, Savitha, Tollerfield, Sally, Wong, Sze Choong, Regan, Fiona
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646833/
https://www.ncbi.nlm.nih.gov/pubmed/37045585
http://dx.doi.org/10.1136/archdischild-2022-325156
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author Mushtaq, Talat
Ali, Salma R
Boulos, Nabil
Boyle, Roisin
Cheetham, Tim
Davies, Justin Huw
Elder, Charlotte Jane
Gan, Hoong-Wei
Hindmarsh, Peter C
Katugampola, Harshini
Krone, Nils
Salomon Estebanez, Maria
Shenoy, Savitha
Tollerfield, Sally
Wong, Sze Choong
Regan, Fiona
author_facet Mushtaq, Talat
Ali, Salma R
Boulos, Nabil
Boyle, Roisin
Cheetham, Tim
Davies, Justin Huw
Elder, Charlotte Jane
Gan, Hoong-Wei
Hindmarsh, Peter C
Katugampola, Harshini
Krone, Nils
Salomon Estebanez, Maria
Shenoy, Savitha
Tollerfield, Sally
Wong, Sze Choong
Regan, Fiona
author_sort Mushtaq, Talat
collection PubMed
description Adrenal insufficiency (AI) is characterised by lack of cortisol production from the adrenal glands. This can be a primary adrenal disorder or secondary to adrenocorticotropic hormone deficiency or suppression from exogenous glucocorticoids. Symptoms of AI in children may initially be non-specific and include growth faltering, lethargy, poor feeding, weight loss, abdominal pain, vomiting and lingering illnesses. AI is treated with replacement doses of hydrocortisone. At times of physiological stress such as illness, trauma or surgery, there is an increased requirement for exogenous glucocorticoids, which if untreated can lead to an adrenal crisis and death. There are no unified guidelines for those <18 years old in the UK, leading to substantial variation in the management of AI. This paper sets out guidance for intercurrent illness, medical, dental and surgical procedures to allow timely and appropriate recognition and treatment of AI and adrenal crisis for children and young people.
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spelling pubmed-106468332023-11-15 Emergency and perioperative management of adrenal insufficiency in children and young people: British Society for Paediatric Endocrinology and Diabetes consensus guidance Mushtaq, Talat Ali, Salma R Boulos, Nabil Boyle, Roisin Cheetham, Tim Davies, Justin Huw Elder, Charlotte Jane Gan, Hoong-Wei Hindmarsh, Peter C Katugampola, Harshini Krone, Nils Salomon Estebanez, Maria Shenoy, Savitha Tollerfield, Sally Wong, Sze Choong Regan, Fiona Arch Dis Child Review Adrenal insufficiency (AI) is characterised by lack of cortisol production from the adrenal glands. This can be a primary adrenal disorder or secondary to adrenocorticotropic hormone deficiency or suppression from exogenous glucocorticoids. Symptoms of AI in children may initially be non-specific and include growth faltering, lethargy, poor feeding, weight loss, abdominal pain, vomiting and lingering illnesses. AI is treated with replacement doses of hydrocortisone. At times of physiological stress such as illness, trauma or surgery, there is an increased requirement for exogenous glucocorticoids, which if untreated can lead to an adrenal crisis and death. There are no unified guidelines for those <18 years old in the UK, leading to substantial variation in the management of AI. This paper sets out guidance for intercurrent illness, medical, dental and surgical procedures to allow timely and appropriate recognition and treatment of AI and adrenal crisis for children and young people. BMJ Publishing Group 2023-11 2023-04-12 /pmc/articles/PMC10646833/ /pubmed/37045585 http://dx.doi.org/10.1136/archdischild-2022-325156 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Review
Mushtaq, Talat
Ali, Salma R
Boulos, Nabil
Boyle, Roisin
Cheetham, Tim
Davies, Justin Huw
Elder, Charlotte Jane
Gan, Hoong-Wei
Hindmarsh, Peter C
Katugampola, Harshini
Krone, Nils
Salomon Estebanez, Maria
Shenoy, Savitha
Tollerfield, Sally
Wong, Sze Choong
Regan, Fiona
Emergency and perioperative management of adrenal insufficiency in children and young people: British Society for Paediatric Endocrinology and Diabetes consensus guidance
title Emergency and perioperative management of adrenal insufficiency in children and young people: British Society for Paediatric Endocrinology and Diabetes consensus guidance
title_full Emergency and perioperative management of adrenal insufficiency in children and young people: British Society for Paediatric Endocrinology and Diabetes consensus guidance
title_fullStr Emergency and perioperative management of adrenal insufficiency in children and young people: British Society for Paediatric Endocrinology and Diabetes consensus guidance
title_full_unstemmed Emergency and perioperative management of adrenal insufficiency in children and young people: British Society for Paediatric Endocrinology and Diabetes consensus guidance
title_short Emergency and perioperative management of adrenal insufficiency in children and young people: British Society for Paediatric Endocrinology and Diabetes consensus guidance
title_sort emergency and perioperative management of adrenal insufficiency in children and young people: british society for paediatric endocrinology and diabetes consensus guidance
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10646833/
https://www.ncbi.nlm.nih.gov/pubmed/37045585
http://dx.doi.org/10.1136/archdischild-2022-325156
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