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Symptomatic glucocorticoid-induced adrenal suppression in the United Kingdom and Ireland: A BPSU study

Lookup NU author(s): Dr Claire WoodORCiD, Dr Laura Lane, Professor Mark PearceORCiD, Professor Timothy CheethamORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).

Abstract

© Author(s) (or their employer(s)) 2024. Objective: To determine the incidence and describe the presentation and management of unexpected symptomatic glucocorticoid-induced adrenal suppression (AS) in children and young people aged 0-15 years. Setting and design: Surveillance study of symptomatic glucocorticoid (GC)-induced AS with supportive biochemical evidence or presenting as an adrenal crisis, reported via the British Paediatric Surveillance Unit (BPSU) from September 2020 to September 2022. Results: Over a 25-month period, 190 reports of symptomatic GC-induced AS/adrenal crisis were made, of which 22 were confirmed cases: 18 AS and 4 adrenal crises. This translates to an incidence rate of 0.09 new cases of GC-induced AS per 100 000 children aged 0-15 per year in the UK. There was a broad range of underlying diagnoses requiring GC prescription (16) and GC preparations (13). Of the 22 patients, 7 had more than 1 type of GC prescribed. The administration of oral GC occurred in 19 of the cases, inhaled GC use in 7, topical use in 5 and 1 case occurred after a single intramuscular injection of GC. All patients were discussed with a paediatric endocrinology team. Conclusions: The incidence of AS from this UK-based BPSU study is lower than a similar Canadian study. This may indicate that paediatricians in the UK and Ireland are becoming more aware of the potential for GC-induced AS and thus are more proactive to prevent its occurrence. The clinical cases still highlight the need to educate families and healthcare professionals with a view to further reducing the morbidity and potential mortality associated with GC-induced AS.

Publication metadata

Author(s): Wood CL, Lane LC, Barlow H, Drake AJ, Kanthagnany S-K, Pearce MS, Sachdev P, Blair JC, Cheetham T

Publication type: Article

Publication status: Published

Journal: Archives of Disease in Childhood

Year: 2025

Volume: 110

Issue: 5

Pages: 363-368

Print publication date: 01/05/2025

Online publication date: 21/12/2024

Acceptance date: 19/10/2024

Date deposited: 13/10/2025

ISSN (print): 0003-9888

ISSN (electronic): 1468-2044

Publisher: BMJ Publishing Group

URL: https://doi.org/10.1136/archdischild-2024-327510

DOI: 10.1136/archdischild-2024-327510

ePrints DOI: 10.57711/s5wa-1p82

Data Access Statement: Data are available upon reasonable request.

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