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Adrenal Insufficiency in Children

Medically reviewed by Last updated on Nov 5, 2023.

What is adrenal insufficiency?

Adrenal insufficiency is a condition that develops because 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 or her body uses sugars, fats, and proteins.

What causes adrenal insufficiency in children?

  • A problem with your child's immune system that makes his or her body attack the adrenal glands
  • An injury that causes the adrenal glands to bleed and prevents the production of adrenal hormones
  • A genetic condition or a family history of adrenal insufficiency
  • An infection that damages the adrenal glands
  • Certain medicines
  • Surgery, tumors, or radiation therapy

What are the signs and symptoms of adrenal insufficiency?

Signs and symptoms depend on your child's age:

  • Newborns and infants:
    • Weakness
    • Vomiting or feeding problems
    • Dry skin and lips
  • 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 diagnosed?

  • Blood tests are used to measure hormone levels and to check for health problems his or her adrenal insufficiency may be causing.
  • Urine tests are used tested to measure the amount of adrenal hormones it contains.
  • Chemical stimulation tests are done 2 times to test your child's blood. The first time it is tested to measure the hormone levels. Then he or she is given a shot of chemicals to cause his adrenal glands to make hormones. His or her blood is tested a second time to see if the hormone levels increased.
  • Genetic screening may be done to see if your child has abnormal genes that are causing the condition. This will also give your child's healthcare provider more information on how to treat the condition.

How is adrenal insufficiency treated?

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

Treatment options

The following list of medications are in some way related to or used in the treatment of this condition.

View more treatment options

What do I need to know about an adrenal crisis?

An adrenal crisis happens when your child's cortisol and aldosterone levels suddenly drop. This may lead to low blood pressure, dehydration, and low blood sugar. An adrenal crisis is life-threatening and needs immediate treatment in a hospital. Your child will be given steroids and glucose (sugar). He or she may be given sodium (salt) and medicine to increase his or her blood pressure. Your child may also need IV fluids to treat dehydration. An adrenal crisis can happen if your child suddenly stops taking his or her medicine. It can also happen when his or her body is under more stress than usual. This may happen during surgery, an illness, or trauma.

When should I seek immediate care?

  • 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.

When should I call my child's doctor?

  • Your child feels dizzy when he or she 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 or she stopped taking it.
  • You have questions or concerns about your child's condition or care.

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 healthcare providers 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.

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