Abstract
Adrenal crises (AC) are life-threatening physiological disturbances that occur at a rate of 5-10/100 patient years in patients with adrenal insufficiency (AI). Despite their seriousness, there is a paucity of information on the epidemiology of AC events in the paediatric population specifically, as most investigations have focused on AI and ACs in adults. Improved surveillance of AC-related morbidity and mortality should improve the delineation of AC risk overall and among different subgroups of paediatric patients with AI. Valid incidence measures are essential for this purpose and also for the evaluation of interventions aimed at reducing adverse health outcomes from ACs. However, the absence of an agreed AC definition limits the potential benefit of research and surveillance in this area. While approaches to the treatment and prevention of ACs have much in common across the lifespan, there are important differences between children and adults with regards to the physiological, psychological, and social milieu in which these events occur. Education is considered to be an essential element of AC prevention but studies have shown that ACs occur even among well-educated patients, suggesting that new strategies may be needed. In this review, we examine the current knowledge regarding AC events in children with AI; assess the existing definitions of an AC and offer a new definition for use in research and the clinic; and suggest areas for further investigation that are aimed at reducing the incidence and health impact of ACs in the paediatric age group.
| Language | English |
|---|---|
| Pages | 341-351 |
| Number of pages | 11 |
| Journal | Hormone Research in Paediatrics |
| Volume | 89 |
| Issue number | 5 |
| DOIs | |
| Publication status | Published - 1 Jul 2018 |
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Adrenal Crises in Children : Perspectives and Research Directions. / Rushworth, R. Louise; Torpy, David J.; Stratakis, Constantine A.; Falhammar, Henrik.
In: Hormone Research in Paediatrics, Vol. 89, No. 5, 01.07.2018, p. 341-351.Research output: Contribution to journal › Review article › Research › peer-review
TY - JOUR
T1 - Adrenal Crises in Children
T2 - Hormone Research in Paediatrics: from developmental endocrinology to clinical research
AU - Rushworth, R. Louise
AU - Torpy, David J.
AU - Stratakis, Constantine A.
AU - Falhammar, Henrik
PY - 2018/7/1
Y1 - 2018/7/1
N2 - Adrenal crises (AC) are life-threatening physiological disturbances that occur at a rate of 5-10/100 patient years in patients with adrenal insufficiency (AI). Despite their seriousness, there is a paucity of information on the epidemiology of AC events in the paediatric population specifically, as most investigations have focused on AI and ACs in adults. Improved surveillance of AC-related morbidity and mortality should improve the delineation of AC risk overall and among different subgroups of paediatric patients with AI. Valid incidence measures are essential for this purpose and also for the evaluation of interventions aimed at reducing adverse health outcomes from ACs. However, the absence of an agreed AC definition limits the potential benefit of research and surveillance in this area. While approaches to the treatment and prevention of ACs have much in common across the lifespan, there are important differences between children and adults with regards to the physiological, psychological, and social milieu in which these events occur. Education is considered to be an essential element of AC prevention but studies have shown that ACs occur even among well-educated patients, suggesting that new strategies may be needed. In this review, we examine the current knowledge regarding AC events in children with AI; assess the existing definitions of an AC and offer a new definition for use in research and the clinic; and suggest areas for further investigation that are aimed at reducing the incidence and health impact of ACs in the paediatric age group.
AB - Adrenal crises (AC) are life-threatening physiological disturbances that occur at a rate of 5-10/100 patient years in patients with adrenal insufficiency (AI). Despite their seriousness, there is a paucity of information on the epidemiology of AC events in the paediatric population specifically, as most investigations have focused on AI and ACs in adults. Improved surveillance of AC-related morbidity and mortality should improve the delineation of AC risk overall and among different subgroups of paediatric patients with AI. Valid incidence measures are essential for this purpose and also for the evaluation of interventions aimed at reducing adverse health outcomes from ACs. However, the absence of an agreed AC definition limits the potential benefit of research and surveillance in this area. While approaches to the treatment and prevention of ACs have much in common across the lifespan, there are important differences between children and adults with regards to the physiological, psychological, and social milieu in which these events occur. Education is considered to be an essential element of AC prevention but studies have shown that ACs occur even among well-educated patients, suggesting that new strategies may be needed. In this review, we examine the current knowledge regarding AC events in children with AI; assess the existing definitions of an AC and offer a new definition for use in research and the clinic; and suggest areas for further investigation that are aimed at reducing the incidence and health impact of ACs in the paediatric age group.
KW - Adrenal crisis
KW - Adrenal insufficiency
KW - Congenital adrenal hyperplasia
KW - Epidemiology
KW - Glucocorticoid
KW - Hypopituitarism
KW - Primary adrenal insufficiency
KW - Secondary adrenal insufficiency
UR - http://www.scopus.com/inward/record.url?scp=85048151013&partnerID=8YFLogxK
U2 - 10.1159/000481660
DO - 10.1159/000481660
M3 - Review article
VL - 89
SP - 341
EP - 351
JO - Hormone Research in Paediatrics: from developmental endocrinology to clinical research
JF - Hormone Research in Paediatrics: from developmental endocrinology to clinical research
SN - 0301-0163
IS - 5
ER -