title: Adrenal insufficiency: still a cause of morbidity and death in childhood.
abstract: Adrenal insufficiency is relatively rare in childhood and adolescence. Signs and symptoms may be nonspecific; therefore, the diagnosis may not be suspected early in the course. If unrecognized, adrenal insufficiency may present with life-threatening cardiovascular collapse. Adrenal crisis continues to occur in children with known primary or secondary adrenal insufficiency during intercurrent illness because of failure to increase glucocorticoid dosage. In this article, current knowledge of the incidence, diagnosis, and treatment of adrenal insufficiency in children and factors precipitating adrenal crisis are summarized. Suggestions for prevention of adrenal crisis in patients at risk are provided for health care professionals and families.
authors.affiliation: Department of Pediatrics, All Children's Hospital, University of South Florida College of Medicine, Tampa, Florida 33701, USA. dshulman@hsc.usf.edu
authors.forename: Dorothy I
authors.initials: DI
authors.lastname: Shulman
authors.forename: Mark R
authors.initials: MR
authors.lastname: Palmert
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Kemp
mesh_terms: D000293:Adolescent; D000309:Adrenal Insufficiency / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D002423:Cause of Death; D002648:Child; D002675:Child, Preschool; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D015994:Incidence; D007223:Infant
chemical_list: D005938:Glucocorticoids