Chronic adrenal insufficiency in children and adolescents

The review articles analyses modern data on etiology, pathogenesis, clinical picture in chronic adrenal insufficiency (CAI) in children and adolescents.It is indicated that, depending on the level of affection of hypothalamo-pituitary-adrenal axis, primary (peripheral) CAI connected with adrenal pat...

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Main Authors: V. V. Smirnov, L. I. Bikbaeva
Format: Article
Language:Russian
Published: Open Systems Publication 2021-06-01
Series:Лечащий Врач
Subjects:
Online Access:https://journal.lvrach.ru/jour/article/view/162
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author V. V. Smirnov
L. I. Bikbaeva
author_facet V. V. Smirnov
L. I. Bikbaeva
author_sort V. V. Smirnov
collection DOAJ
description The review articles analyses modern data on etiology, pathogenesis, clinical picture in chronic adrenal insufficiency (CAI) in children and adolescents.It is indicated that, depending on the level of affection of hypothalamo-pituitary-adrenal axis, primary (peripheral) CAI connected with adrenal pathology, secondary and tertiary (central) CAI are defined. Clinical symptoms of CAI occur in affection of 95% of adrenal cortex tissue. The disease is characterized by latent beginning and slow rise of clinical symptoms. However, in case of congenital adrenal hypoplasia, the disease symptoms may occur soon after the birth.The syndromes combined with deficit of adrenal cortex hormones were described. Primary CAI is a heterogeneous disease. There are hereditary and acquired forms of the disease. Among acquired forms of primary CAI there are infectious lesions (sepsis, more often, of meningococcal or streptococcal etiology, HIV-infection, influenza, congenital syphilis, tuberculosis), adrenal hemorrhage, their tumorous affection, two-sided adrenalectomy.The diagnostics methods and treatment strategy were presented. In CAI, life-length replacement therapy with gluco- and/ or mineralocorticoid drugs is conducted, which support critical function, ensuring organism adaptation to stress influence of the environment and keeping of water-salt balance. The dosage of the drugs used in the replacement therapy is selected individually, and adapted depending on the age of the child. It is recommended, to add kitchen salt and ascorbic acid to the patients’ nutrition, and reduce consuming products containing potassium.
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spelling doaj.art-8b51ffbc9e7c4e78b2fd695444da927c2025-03-02T09:07:13ZrusOpen Systems PublicationЛечащий Врач1560-51752687-11812021-06-01075257161Chronic adrenal insufficiency in children and adolescentsV. V. Smirnov0L. I. Bikbaeva1N. I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian FederationN. I. Pirogov Russian National Research Medical University of the Ministry of Healthcare of the Russian FederationThe review articles analyses modern data on etiology, pathogenesis, clinical picture in chronic adrenal insufficiency (CAI) in children and adolescents.It is indicated that, depending on the level of affection of hypothalamo-pituitary-adrenal axis, primary (peripheral) CAI connected with adrenal pathology, secondary and tertiary (central) CAI are defined. Clinical symptoms of CAI occur in affection of 95% of adrenal cortex tissue. The disease is characterized by latent beginning and slow rise of clinical symptoms. However, in case of congenital adrenal hypoplasia, the disease symptoms may occur soon after the birth.The syndromes combined with deficit of adrenal cortex hormones were described. Primary CAI is a heterogeneous disease. There are hereditary and acquired forms of the disease. Among acquired forms of primary CAI there are infectious lesions (sepsis, more often, of meningococcal or streptococcal etiology, HIV-infection, influenza, congenital syphilis, tuberculosis), adrenal hemorrhage, their tumorous affection, two-sided adrenalectomy.The diagnostics methods and treatment strategy were presented. In CAI, life-length replacement therapy with gluco- and/ or mineralocorticoid drugs is conducted, which support critical function, ensuring organism adaptation to stress influence of the environment and keeping of water-salt balance. The dosage of the drugs used in the replacement therapy is selected individually, and adapted depending on the age of the child. It is recommended, to add kitchen salt and ascorbic acid to the patients’ nutrition, and reduce consuming products containing potassium.https://journal.lvrach.ru/jour/article/view/162adrenal glandshypocorticismhypoaldosteronismhyponatremiahyperkalemiachildren
spellingShingle V. V. Smirnov
L. I. Bikbaeva
Chronic adrenal insufficiency in children and adolescents
Лечащий Врач
adrenal glands
hypocorticism
hypoaldosteronism
hyponatremia
hyperkalemia
children
title Chronic adrenal insufficiency in children and adolescents
title_full Chronic adrenal insufficiency in children and adolescents
title_fullStr Chronic adrenal insufficiency in children and adolescents
title_full_unstemmed Chronic adrenal insufficiency in children and adolescents
title_short Chronic adrenal insufficiency in children and adolescents
title_sort chronic adrenal insufficiency in children and adolescents
topic adrenal glands
hypocorticism
hypoaldosteronism
hyponatremia
hyperkalemia
children
url https://journal.lvrach.ru/jour/article/view/162
work_keys_str_mv AT vvsmirnov chronicadrenalinsufficiencyinchildrenandadolescents
AT libikbaeva chronicadrenalinsufficiencyinchildrenandadolescents