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Fifteen-minute consultation: An approach to the child receiving glucocorticoids
  1. Sai-Kalyani Kanthagnany1,
  2. Laura C Lane2,3,
  3. Claire Wood2,3,
  4. Pooja Sachdev1,
  5. Amanda Jane Drake4,
  6. Timothy Cheetham2,3
  1. 1Paediatrics, Nottingham University Hospitals NHS Trust, Nottingham, UK
  2. 2Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne, UK
  3. 3Department of Paediatric Endocrinology, Great North Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, UK
  4. 4University/BHF Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr Timothy Cheetham, Paediatric Endocrinology, Great North Children's Hospital, Royal Victoria Infirmary, Newcastle upon Tyne, United Kingdom; timothy.cheetham{at}newcastle.ac.uk

Abstract

Glucocorticoids (GC) are used in paediatric practice for a broad range of conditions and all paediatricians will prescribe GC, in some form, during their career. A wide variety of GC formulations, doses and administration routes are used for periods of time ranging from days to years. Exposure to exogenous GC can result in hypothalamic-pituitary-adrenal axis suppression—otherwise known as adrenal suppression (AS). Patients with AS may be well most of the time but if GC therapy is reduced or stopped or if additional endogenous GC cannot be generated during illness, then an absolute or relative lack of GC can result in severe illness or death. Here, we highlight the relevance of AS to all paediatricians by providing an overview of the background and discussing the presentation and approaches to the management of this clinical entity.

  • glucocorticoids
  • adrenal suppression
  • HPA axis suppression
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Footnotes

  • Twitter @TeamDrakeUofE

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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