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Adrenal Insufficiency In Children

WHAT YOU NEED TO KNOW:

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.

WHILE YOU ARE HERE:

Informed consent

is a legal document that explains the tests, treatments, or procedures that your child may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your child's medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done to your child. Make sure all of your questions are answered.

Heart monitor:

This is also called an ECG or EKG. Sticky pads placed on your child's skin record the electrical activity of his heart.

An IV

is a small tube placed in your child's vein that is used to give him medicine or liquids.

Vital signs:

Caregivers will check your child's blood pressure, heart rate, breathing rate, and temperature. They will also ask you or your child about his pain. These vital signs give caregivers information about your child's current health.

Weight:

Your child may be weighed each day. Healthcare providers compare your child's weight from day to day. This helps healthcare providers see how much body fluid your child has. If your child loses too much body fluid he can become dehydrated. If he has too much body fluid, he may have trouble breathing and become swollen. Your child's body does not work well when it has too much or too little fluid.

Medicine:

  • Steroid medicine: Steroids are given to balance the steroid hormones levels your child's adrenals naturally make. This medicine may help your child feel better, but may also have unwanted effects. He may need to take this medicine for the rest of his life. You may need to change how much medicine he takes if he is ill or has increased stress. Ask your child's healthcare provider when to increase his medicine. Do not stop giving this medicine to your child without talking to your healthcare provider. Stopping on your own may cause him to have a very bad response.

Tests:

Your child may have any of the following tests:

  • Blood tests: Your child may need blood tests to give caregivers information about how his body is working. The blood may be taken from your child's arm, hand, finger, foot, heel, or IV.
  • Chemical stimulation tests: Your child's blood is tested first and then he is given a shot of special chemicals. The chemicals will cause his adrenal glands to make hormones. After several minutes, his hormone levels in his blood will be checked again. Ask your child's healthcare provider for information about this test.
  • 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 healthcare provider more information on how to treat his condition.
  • Imaging tests: These tests may be done to see the size of your child's adrenal glands. They may also be done to check your child's adrenal glands for cancer, bleeding, or infection.
    • Abdominal ultrasound: An abdominal ultrasound is a test that is done to see inside your child's body. Sound waves are used to show pictures of different body organs on a TV-like screen.
    • A CT , or CAT scan, takes pictures of your child's body. Your child may be given contrast liquid before the scan. Tell a healthcare provider if your child has ever had an allergic reaction to contrast liquid.
    • MRI: An MRI uses a powerful magnet and radio waves to take pictures of the inside of your child's body. Caregivers may use the MRI to look at your child's brain, muscles, joints, bones, or blood vessels. Your child will need to lie still during his test. Never enter the MRI room with any metal objects. This can cause serious injury.
  • Urine test: This may include measuring the amount of adrenal hormones in your child's urine. Ask your child's healthcare provider for more information about this test.

Treatment options:

  • Intravenous therapy: This is a special liquid given to keep the fluid balance in your child's body normal.
  • Sodium chloride (salt): Infants with adrenal insufficiency may lose body salt through their sweat or urine. The salt must be replaced right away for his body to work well. Salt supplements may also be given because formula and breast milk may not have enough. They may be given daily as ordered by his healthcare provider.

RISKS:

  • 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.

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.

© 2016 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.

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.

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