BSPED consensus guidelines: emergency and peri-operative management of adrenal insufficiency in children and young people

Mushtaq, Talat; Gan, Hoong-Wei

doi:10.1530/endoabs.85.emm2.1

Cited by 4 publications

(4 citation statements)

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“…They should also be advised to attend emergency services if their child cannot tolerate oral intake, for example during gastroenteritis, as they will need intravenous or intramuscular administration of hydrocortisone in this context. Relevant guidelines on paediatric adrenal insufficiency, such as those from the British Society of Paediatric Diabetes and Endocrinology, can be consulted for further detail 9 . Specific guidelines exist for management of adrenal insufficiency – iatrogenic or otherwise – in the perioperative period 10 …”

Section: Discussionmentioning

confidence: 99%

Characterising approaches to steroid therapy in paediatric multisystem inflammatory syndrome temporally associated with SARS‐CoV‐2

McGlacken-Byrne

Johnson

Penner

et al. 2023

J Paediatrics Child Health

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Aim We describe approaches to steroid therapy use in paediatric multisystem inflammatory syndrome temporally associated with SARS‐CoV‐2 (PIMS‐TS) and examine the association between steroid therapy and key clinical markers of severity. Methods We conducted a retrospective review of children (<18 years) admitted to a tertiary paediatric hospital in the UK with PIMS‐TS. We collected data on if and why steroid therapy was used; the duration, type and dosing of steroids prescribed; and approaches to hypothalamo‐pituitary‐adrenal (HPA) axis monitoring, if performed. We examined associations between steroid exposure/total steroid dose (mg/m2/day) and paediatric intensive care unit admission, mechanical ventilation and inotropic support. Results Steroid therapy was commenced in most children (84.9%, n = 104) with a median total daily steroid dose (hydrocortisone equivalent) of 271.0 mg/m2/day (interquartile range 232.5–355.5) and treatment length of 26.0 days (interquartile range 19.0–32.0). Dosing regimens predominantly involved a short course of high‐dose methylprednisolone followed by tapering oral prednisolone. Basal and/or dynamic testing of the HPA axis was conducted in a minority (11.8%, n = 15) and was normal. Duration of steroid therapy correlated positively with durations of paediatric intensive care unit admission (r = 0.407, P < 0.001) and mechanical ventilation (r = 0.797, P < 0.001). A greater proportion of children receiving steroid therapy also received inotropic support compared to those that did not receive steroid therapy (71.4% vs. 45.5%, P = 0.025). Conclusion Prolonged, high‐dose steroid therapy is often used in the management of severe PIMS‐TS with the potential for HPA axis suppression and should be withdrawn carefully.

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Section: Discussionmentioning

confidence: 99%

Characterising approaches to steroid therapy in paediatric multisystem inflammatory syndrome temporally associated with SARS‐CoV‐2

McGlacken-Byrne

Johnson

Penner

et al. 2023

J Paediatrics Child Health

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“…It included practical recommendations on oral steroid sick day dosing plans, which was not included in the 2018 international Care Considerations. The guidance is due to be revised to ensure alignment with UK national guidance for acute management of paediatric adrenal insufficiency developed by BSPED in 2022, which also includes hospital management of adrenal insufficiency during acute emergencies and during the peri-operative period [71]. Other outputs from this workstream in DMD Care UK include patient information leaflets on delayed puberty, adrenal insufficiency and osteoporosis which includes information on plans to mitigate first dose bisphosphonate reactions.…”

Section: The Duchenne Centre Netherlands Approach In the Netherlandsmentioning

confidence: 99%

Moving Beyond the 2018 Minimum International Care Considerations for Osteoporosis Management in Duchenne Muscular Dystrophy (DMD): Meeting Report from the 3rd International Muscle-Bone Interactions Meeting 7th and 14th November 2022

Phung,

Crabtree,

Connolly

et al. 2024

JND

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“…Advise on a stress dose for periods of physiological stress, for example, illness, trauma and surgery. Further guidance on this can be obtained on the new British Society of Paediatric Endocrinology and Diabetes consensus recommendations 10…”

Section: General Strategies For Minimising the Risks Of Adverse Effec...mentioning

confidence: 99%

Recommendations for minimising and monitoring adverse effects of long-term supraphysiological corticosteroid use in children and young persons

Micallef,

Chana

2023

Arch Dis Child Educ Pract Ed

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BSPED consensus guidelines: emergency and peri-operative management of adrenal insufficiency in children and young people

Cited by 4 publications

References 0 publications

Characterising approaches to steroid therapy in paediatric multisystem inflammatory syndrome temporally associated with SARS‐CoV‐2

Characterising approaches to steroid therapy in paediatric multisystem inflammatory syndrome temporally associated with SARS‐CoV‐2

Moving Beyond the 2018 Minimum International Care Considerations for Osteoporosis Management in Duchenne Muscular Dystrophy (DMD): Meeting Report from the 3rd International Muscle-Bone Interactions Meeting 7th and 14th November 2022

Recommendations for minimising and monitoring adverse effects of long-term supraphysiological corticosteroid use in children and young persons

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