Latest Insights on the Etiology and Management of Primary Adrenal Insufficiency in Children

Güran, Tülay

doi:10.4274/jcrpe.2017.s002

Cited by 21 publications

(23 citation statements)

References 45 publications

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“…Presence of bilious vomiting, severe abdominal pain, abdominal distension, failure to pass the meconium may help to differentiate from FPIES and abdominal X‐ray, upper gastrointestinal series and abdominal ultrasound may be necessary to establish proper care (Table ) . Intracranial mass and acute adrenal insufficiency (eg congenital adrenal hyperplasia (CAH)), present with vomiting, dehydration, hyponatremia and hyperkalaemia and can mimic acute FPIES …”

Section: Fpies On a Spectrum Of Gi Food Allergic Disorder‐differentiamentioning

confidence: 99%

Food protein‐induced enterocolitis syndrome

Caubet

Cianferoni

Groetch

et al. 2019

Clin Experimental Allergy

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Food protein‐induced enterocolitis syndrome (FPIES) is a non‐IgE‐mediated gastrointestinal food allergic disorder that has gained a major interest the past decade. FPIES prevalence, which still needs to be accurately determine in different populations, appears to be higher than previously thought (ie up to 0.7% in infants in the 1st year of life). FPIES to seafood in adults is also increasingly reported; limited data suggest that adult FPIES is most commonly triggered by shellfish, tends to affect females more than men, is characterized by a significant delay in diagnosis and a prolonged course. The first international consensus guidelines on diagnosis and management of FPIES have been published in 2017, proposing new diagnostic criteria as well as new criteria for a positive oral food challenge. However, there is a need to develop new biomarkers to improve the diagnosis and management of FPIES patients, and this requires a better understanding of the pathophysiology. Recently, the role of T cells has been questioned and a major role of innate immune cells has been suggested in acute FPIES. Regarding the treatment of acute FPIES reaction, ondansetron has emerged as an adjunct to intravenous rehydration in moderate‐severe reactions and as a first‐line treatment in mild reactions. Important information regarding the nutritional management of FPIES patients that might be complex has also been provided in the international guidelines. In this review, we discuss recent advances regarding all those different aspects.

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Section: Fpies On a Spectrum Of Gi Food Allergic Disorder‐differentiamentioning

confidence: 99%

Food protein‐induced enterocolitis syndrome

Caubet

Cianferoni

Groetch

et al. 2019

Clin Experimental Allergy

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“…Primary adrenal insufficiency is a rare clinical condition characterized by the insufficient production of the steroid hormones from the adrenal cortex, such as cortisol, aldosterone, and adrenal sex steroids, affecting both genders equally in childhood [22][23][24]. The main treatment of PAI is replacing glucocorticoids and mineralocorticoids, principally by hydrocortisone and fludrocortisone [21,22]. The recommended dosage for hydrocortisone ranges between 7.5-15 mg/m 2 /day, according to the underlying cause [25][26][27].…”

Section: Discussionmentioning

confidence: 99%

Does fludrocortisone treatment cause hypomagnesemia in children with primary adrenal insufficiency?

et al. 2021

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Background: Aldosterone is a mineralocorticoid that secreted from adrenal glands and a known factor to increase magnesium excretion by direct and indirect effects on renal tubular cells. Although the frequency of hypomagnesemia was found to be approximately 5% in adult studies, there is no study in the literature investigating the frequency of hypomagnesemia in children that using fludrocortisone, which has a mineralocorticoid activity. Materials and methods: A multi-center retrospective study was conducted, including children who were under fludrocortisone treatment for primary adrenal insufficiency and applied to participant pediatric endocrinology outpatient clinics. Results: Forty-three patients (58.1% male, 41.9% prepubertal) included in the study, whose median age was 9.18 (0.61-19) years, and the most common diagnosis among the patients was a salt-wasting form of congenital adrenal hyperplasia (67.4%). Mean serum magnesium level was 2.05 (±0.13) mg/dL and hypomagnesemia was not observed in any of the patients treated with fludrocortisone. None of the patients had increased urinary excretion of magnesium. Conclusions: Unlike the studies performed in adults, we could not find any evidence of magnesium wasting effect of fludrocortisone treatment with normal or even high doses in children and adolescents.

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“…For many GN diseases, cellular immunity plays a decisive role, and humoral immunity is also clearly expressed during the pathogenic process of GN diseases ( 14 ). In addition, the disorder of blood coagulation mechanism and the change of blood rheology have an effect on the occurrence and progression of glomerular diseases ( 15 ). In clinic, the pathogenesis and treatment of GN are known, the drugs used to treat GN are immunosuppressive agents and glucocorticoid, but the efficacy of many glomerular diseases is still unsatisfactory ( 16 , 17 ).…”

Section: Discussionmentioning

confidence: 99%

Changes of expression levels of serum cystatin C and soluble vascular endothelial growth factor receptor 1 in the treatment of patients with glomerulus nephritis

Qin

Yan

2020

Exp Ther Med

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Expression levels and changes of serum cystatin C (C's C) and soluble vascular endothelial growth factor receptor 1 (sVEGFR1) in treatment of patients with glomerulus nephritis (GN) were investigated. The medical records of 88 patients with GN who were diagnosed in Weifang People's Hospital from March 2014 to June 2017 were collected, and their medical records were considered as a study group. The study group was divided into secondary glomerulonephritis (SGN) group (52 cases) and primary glomerulonephritis (PGN) group (36 cases). Physical examination data of 50 healthy volunteers who were examined in the same hospital during the same period were considered as a control group. The correlation between expression of serum C's C and expression of sVEGFR1 of patients with GN was compared. Expression levels of serum C's C and sVEGFR1 of patients before treatment in the study group were higher than those in the control group (P<0.05). With the extension of the treatment cycle, C's C and sVEGFR1 expression levels in PGN and SGN groups reduced gradually (P<0.05). With the extension of the treatment cycle, the renal function indexes of the study group patients showed a downward trend (P<0.05). Expression of C's C was positively correlated with urea nitrogen and creatinine (P<0.05). In conclusion, C's C and sVEGFR1 are highly expressed in the serum of patients with GN. Expression of C's C and sVEGFR1 decrease as patients are treated. C's C and sVEGFR1 can be used as indicators for monitoring the condition of patients with GN. It is worthwhile to promote C's C and sVEGFR1 in clinical practice.

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Latest Insights on the Etiology and Management of Primary Adrenal Insufficiency in Children

Cited by 21 publications

References 45 publications

Food protein‐induced enterocolitis syndrome

Food protein‐induced enterocolitis syndrome

Does fludrocortisone treatment cause hypomagnesemia in children with primary adrenal insufficiency?

Changes of expression levels of serum cystatin C and soluble vascular endothelial growth factor receptor 1 in the treatment of patients with glomerulus nephritis

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