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Studies have demonstrated that younger children with congenital adrenal hyperplasia experience adrenal crisis events more frequently than older children and adolescents. [53] Psychosocial factors can alter the baseline adrenal crisis risk, especially as the transition from parental treatment oversight to self-management in adolescence. [ 54 ]
The most common cause of primary adrenal insufficiency (Addison's disease) overall is autoimmune adrenalitis. [2] The prevalence of Addison's disease ranges from 5 to 221 per million in different countries. [31] In children, congenital adrenal hyperplasia (CAH) is the most common cause of adrenal insufficiency, with an incidence 1 in 14,200 ...
An "adrenal crisis" or "Addisonian crisis" is a constellation of symptoms that indicates severe adrenal insufficiency. This may be the result of either previously undiagnosed Addison's disease, a disease process suddenly affecting adrenal function (such as adrenal hemorrhage ), or an intercurrent problem (e.g., infection, trauma) in someone ...
Adrenal crisis is a serious, life-threatening complication of adrenal insufficiency. Hypotension , or hypovolemic shock , is the main symptom of adrenal crisis, other indications and symptoms include weakness , anorexia , nausea , vomiting, fever, fatigue , abnormal electrolytes , confusion , and coma. [ 19 ]
Even after diagnosis and initiation of treatment, a small percentage of children and adults with infancy or childhood onset CAH die of adrenal crisis. [4] Deaths from this are entirely avoidable if the child and family understand that the daily glucocorticoids cannot be allowed to be interrupted by an illness.
Vomiting, diarrhea, or other causes of poor intestinal absorption necessitate the administration of intravenous hydrocortisone. [2] Acute adrenal crisis requires intravenous administration of 100 mg hydrocortisone immediately, followed by 100–200 mg over the next 24 hours and large volumes of saline while under continuous cardiac monitoring. [15]
Congenital adrenal hyperplasia (CAH) is a group of autosomal recessive disorders characterized by impaired cortisol synthesis. [ 1 ] [ 2 ] It results from the deficiency of one of the five enzymes required for the synthesis of cortisol in the adrenal cortex . [ 3 ]
Of the causes of medication induced syndrome of inappropriate antidiuresis, antidepressants (especially SSRIs) are the most common culprit. [2] Central nervous system (CNS) disorders or conditions may cause SIADH in 9% of cases, this includes subarachnoid hemorrhage (56% of CNS causes), pituitary surgery (35% of CNS causes), brain cancer ...