Aggiornamento
Insufficienza surrenalica: rara ma non troppo
Adrenal insufficiency: it is not too rare
Giuseppa Patti1,2, Gianluca Tornese1,2, Maria Chiara Pellegrin1,2, Katy Vecchiato1,2, Elena Faleschini1, Alessandro Ventura1,2
1IRCCS Materno-Infantile “Burlo Garofolo”, Trieste; 2Universitŕ di Trieste
Gennaio 2016 - pagg. 21 -26
Abstract
Adrenal insufficiency is a rare condition in childhood. Clinical characteristics of adrenal
insufficiency in children may be non-specific. Therefore, the diagnosis may be suspected
late. If unrecognized, adrenal insufficiency may present with life-threatening cardiovascular
collapse. In this article, current knowledge of the clinical manifestations, diagnosis,
and treatment of adrenal insufficiency in children and factors precipitating adrenal crisis
are summarized.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Contenuto riservato
Per leggere l'articolo completo è necessario effettuare il login.
Non sei ancora registrato? Registrati
Bibliografia
1. Shulman DI, Palmert MR, Kemp SF; Lawson
Wilkins Drug and Therapeutics Committee.
Adrenal insufficiency: still a cause of morbidity
and death in childhood. Pediatrics
2007;119(2):e484-94.
2. Malikova J, Flück CE. Novel insight into etiology,
diagnosis and management of primary
adrenal insufficiency. Horm Res Paediatr 2014;
82(3):145-57.
3. Arlt W, Allollo B. Adrenal insufficiency. Lancet
2003;361:1881-93.
4. Balsamo A, Cicognani A. Sindrome adrenogenitale
congenita da deficit di 21-idrossilasi.
Medico e Bambino 2005;24(5):293-301.
5. White PC, Speiser PW. Congenital adrenal
hyperplasia due to 21-hydroxylase deficiency.
Endocr Rev 2000;21:245-91.
6. Taddio A, Valencic E, Maschio F, Tommasini
A. Immunodeficienza e autoimmunitŕ. Medico
e Bambino 2005;24(10):653-8.
7. Milenkovic T, Zdravkovic D, Savic N, et al.
Triple A syndrome: 32 years experience of a
single centre (1977-2008). Eur J Pediatr 2010;
169(11):1323-8.
8. Felner EI, Thompson MT, Ratliff AF, White
PC, Dickson BA. Time course of recovery of
adrenal function in children treated for leukemia.
J Pediatr 2000;137:21-4.
9. Stewart PM. The adrenal cortex. In: Larsen
PR, Kronenberg HM, Melmed S, Polonsky KS
(Eds). Williams Textbook of Endocrinology,
10th ed. Philadelphia, PA: Saunders, 2003:491-
551.
10. Felner EI, Thompson MT, Ratliff AF, White
PC, Dickson BA. Time course of recovery
of adrenal function in children treated for
leukemia. J Pediatr 2000;137(1):21-4.
11. Nelson Textbook of Pediatrics. 19th edition.
12. Butler G, Kirk J. OSH Paediatric endocrinology
and diabetes. Oxford specialist handbooks
in paediatrics. Oxford University Press, 2011
13. Binder G, Bosk A, Gass M, Ranke MB,
Heidemann PH. Insulin tolerance test causes
hypokalaemia and can provoke cardiacarrhythmias.
Horm Res 2004;62:84-7.
14. Bottner A, Kratzsch J, Liebermann S, et al.
Comparison of adrenal function tests in children:
the glucagon stimulation test allows the
simultaneous assessment of adrenal function
and growth hormone response in children. J
Pediatr Endocrinol Metab 2005;18:433-42.
15. Ranke MB, Mullis PE (Eds). Diagnostic of
endocrine function in children and adolescents.
4th revisited and extended edition,
2011.
16. Maghnie M, Uga E, Temporini F, et al. Evaluation
of adrenal function in patients with
growth hormone deficiency and hypothalamicpituitary
disorders: comparison between insulininduced
hypoglycemia, low-dose ACTH,
standard ACTH and CRH stimulation tests. Eur
J Endocrinol 2005;152:735-41.
17. Tonini G, Bernasconi S, Bona G, et al. Le
urgenze endocrinologiche. Medico e Bambino
2003;22(9):590-5.
18. Karagüzel G, Cakir E. Adrenal dysfunction
in critically ill children. Minerva Endocrinol
2014;39(4):235-43.
19. Menon K, Clarson C. Adrenal function in
pediatric critical illness. Pediatr Crit Care Med
2002;3(2):112-6.
20. den Brinker M, Joosten KF, Liem O, et al.
Adrenal insufficiency in meningococcal sepsis:
bioavailable cortisol levels and impact of
interleukin-6 levels and intubation with etomidate
on adrenal function and mortality. J Clin
Endocrinol Metab 2005;90(9):5110-7.
21. den Brinker M, Hokken-Koelega AC, Hazelzet
JA, de Jong FH, Hop WC, Joosten KF.
One single dose of etomidate negatively influences
adrenocortical performance for at
least 24h in children with meningococcal sepsis.
Intensive Care Med 2008;34(1):163-8.
22. Rose SR, Auble BA. Endocrine changes after
pediatric traumatic brain injury. Pituitary
2012;15(3):267-75.
23. Giavoli C, Libe R, Corbetta S, et al. Effect of
recombinant human growth hormone (GH)
replacement on the hypothalamic-pituitaryadrenal
axis in adult GH-deficient patients. J
Clin Endocrinol Metab 2004;89:5397-401.
24. Shaikh MG, Lewis P, Kirk JM. Thyroxine
unmasks Addison’s disease. Acta Paediatr
2004;93:1663-5.
25. Havard CW, Saldanha VF, Bird R, Gardner
R. Adrenal function in hypothyroidism. BMJ
1970;1(5692):337-9.
Corrispondenza: giusypattis@gmail.com