Prevalence of adrenal insufficiency following systemic glucocorticoid therapy in infants with hemangiomas.
OBJECTIVE
To determine the prevalence of adrenal insufficiency in infants with hemangiomas following treatment with systemic glucocorticoids (GCs).


METHODS
Prospective study for 18 months.


METHODS
Hemangioma and vascular malformation center at a tertiary care children's hospital.


METHODS
Sixteen infants with hemangiomas had an adrenal axis evaluation as soon as possible following the completion of GC therapy. Ten healthy control infants were also evaluated for comparison.


METHODS
Prednisolone at a starting dose of 2 to 3 mg/kg/d for 4 weeks, followed by a tapering period. The mean duration of GC treatment was 7.2 months.


METHODS
Prevalence of adrenal insufficiency in GC-treated subjects as assessed by a combination low-dose/high-dose corticotropin stimulation test.


RESULTS
Subjects underwent corticotropin testing at a mean of 13 days after the completion of therapy. Only 1 of the 16 GC-treated infants (6%) had adrenal insufficiency. This subject was tested 1 day after GC treatment was stopped, and results from retesting 3 months later were normal. All control subjects had normal adrenal function.


CONCLUSIONS
Infants with hemangiomas are at low risk of adrenal insufficiency following the completion of GC therapy, as used in our hemangioma center.
Lomenick
Jefferson P
JP
Division of Endocrinology, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA. jefferson.lomenick@vanderbilt.edu
Reifschneider
Kent L
KL
Lucky
Anne W
AW
Adams
Denise
D
Azizkhan
Richard G
RG
Woo
Jessica G
JG
Backeljauw
Philippe F
PF
D000309:Adrenal Insufficiency / Q000139:chemically induced* / Q000175:diagnosis; D003366:Cosyntropin; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006391:Hemangioma / Q000151:congenital / Q000188:drug therapy*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects; D007223:Infant; D008297:Male; D010913:Pituitary-Adrenal System / Q000187:drug effects; D011239:Prednisolone / Q000009:adverse effects* / Q000627:therapeutic use; D012878:Skin Neoplasms / Q000151:congenital / Q000188:drug therapy*
D005938:Glucocorticoids; D003366:Cosyntropin; D011239:Prednisolone; D006854:Hydrocortisone