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Adrenal Insufficiency In Children

What is adrenal insufficiency in children?

Adrenal insufficiency is a condition that develops when your child's adrenal glands do not make enough adrenal hormones. Adrenal hormones such as cortisol help your child's body handle stress, keep blood pressure normal, and balance salt and fluids. They control how his body uses sugars, fats, and proteins. An adrenal crisis may happen if your child's adrenal hormones become too low. This condition is life-threatening and needs immediate treatment.

What causes adrenal insufficiency in children?

  • Autoimmune disorders: A problem with your child's immune system may make his body attack his adrenal glands.

  • Injury: Injury to your child's adrenal glands may make them bleed, which can prevent the production of adrenal hormones. Trauma may happen when a mother has trouble giving birth to her child. Ask your child's caregiver for more information about causes of adrenal bleeding.

  • Genetic conditions: Your child may have been born with genes that caused the condition. Your child's risk of adrenal insufficiency is greater if he has a family member with this type of genetic condition.

  • Infections: Your child's adrenal glands may be damaged by certain infections.

  • Medicines: Certain medicines may cause adrenal insufficiency. Long-term treatment with steroid medicines for other conditions commonly causes adrenal insufficiency. This may be temporary or permanent. Ask your child's caregiver if any of the medicines your child takes can cause adrenal insufficiency.

  • Other causes: Surgery, tumors, or radiation therapy may cause damage to your child's adrenal glands.

What are the signs and symptoms of adrenal insufficiency in children?

The signs and symptoms of adrenal insufficiency depend on your child's age.

  • Signs and symptoms in newborns or infants:

    • Weakness

    • Vomiting or feeding problems

    • Dry skin and lips

  • Signs and symptoms in older children:

    • Stomach pain, muscle weakness, or muscle pains

    • Tiredness, dizziness, or trouble thinking clearly

    • Craving salty foods, decrease in appetite, or weight loss

    • Decreased or absent pubic hairs

    • Skin color changes, especially on sun-exposed areas

How is adrenal insufficiency in children diagnosed?

  • Blood tests: Your child's blood is tested to measure hormone levels and to check for health problems his adrenal insufficiency may be causing.

  • Urine tests: Your child's urine is tested to measure the amount of adrenal hormones it contains.

  • Chemical stimulation tests: Your child's blood is tested twice in this test. The first time it is tested to measure the hormone levels. Then he is given a shot of chemicals to cause his adrenal glands to make hormones. His blood is tested a second time to see if the hormone levels increased.

  • Genetic screening: This may be done to see if your child has abnormal genes that are causing his condition. This will also give your child's caregiver more information on how to treat his condition.

How is adrenal insufficiency in children treated?

Steroid medicine is given to balance the steroid hormone levels your child's adrenals naturally make. He may need to take this medicine for the rest of his life. You may need to change the amount he takes if he is ill or has increased stress. Ask your child's caregiver when and how much to increase his medicine. Do not stop giving this medicine to your child before you talk to his caregiver. Your child can trigger an adrenal crisis if he stops taking steroids suddenly.

What are the risks of adrenal insufficiency?

  • Medicines used to treat adrenal insufficiency may cause an allergic reaction. Replacement steroid medicine may cause your child to put on extra fat in his face, abdomen, and neck. He may feel weak, bruise easily, and have poor wound healing. He may have a fast heartbeat. Treatment can make his bones brittle and break more easily.

  • Adrenal insufficiency that is not treated can lead to a life-threatening condition called adrenal crisis. Adrenal crisis can make your child lose too much fluid, drop his blood pressure, and put him into a coma.

When should I contact my child's caregiver?

Contact your child's caregiver if:

  • Your child feels dizzy when he stands up.

  • Your child has a fever.

  • Your child has nausea, vomiting, or stomach pain.

  • Your child is sweating more than usual.

  • Your child does not have any more medicine, or he stopped taking it.

  • You have questions or concerns about your child's condition or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

  • Your child has chills or a high fever.

  • Your child has dry skin and lips, and is very thirsty.

  • Your child faints.

  • Your child refuses to eat or drink.

Care Agreement

You have the right to help plan your child's care. Learn about your child's health condition and how it may be treated. Discuss treatment options with your child's caregivers to decide what care you want for your child. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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