Prevalence of Adrenal Insufficiency Following Systemic Glucocorticoid Therapy in Infants With Hemangiomas

Lomenick JP, Reifschneider KL, Lucky AW, et al. — Sun, 01 Mar 2009 00:00:00 GMT

Objective

To determine the prevalence of adrenal insufficiency in infants with hemangiomas following treatment with systemic glucocorticoids (GCs).

Design

Prospective study for 18 months.

Setting

Hemangioma and vascular malformation center at a tertiary care children's hospital.

Patients

Sixteen infants with hemangiomas had an adrenal axis evaluation as soon as possible following the completion of GC therapy. Ten healthy control infants were also evaluated for comparison.

Interventions

Prednisolone at a starting dose of 2 to 3 mg/kg/d for 4 weeks, followed by a tapering period. The mean duration of GC treatment was 7.2 months.

Main Outcome Measure

Prevalence of adrenal insufficiency in GC-treated subjects as assessed by a combination low-dose/high-dose corticotropin stimulation test.

Results

Subjects underwent corticotropin testing at a mean of 13 days after the completion of therapy. Only 1 of the 16 GC-treated infants (6%) had adrenal insufficiency. This subject was tested 1 day after GC treatment was stopped, and results from retesting 3 months later were normal. All control subjects had normal adrenal function.

Conclusion

Infants with hemangiomas are at low risk of adrenal insufficiency following the completion of GC therapy, as used in our hemangioma center.

JAMA Dermatology: Adrenal Diseases Topic Collection

Prevalence of Adrenal Insufficiency Following Systemic Glucocorticoid Therapy in Infants With Hemangiomas