Prevalence of adrenal insufficiency following systemic glucocorticoid therapy in infants with hemangiomas

Arch Dermatol. 2009 Mar;145(3):262-6. doi: 10.1001/archdermatol.2008.572.

Abstract

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adrenal Insufficiency / chemically induced*
  • Adrenal Insufficiency / diagnosis
  • Cosyntropin
  • Female
  • Glucocorticoids / adverse effects*
  • Glucocorticoids / therapeutic use
  • Hemangioma / congenital
  • Hemangioma / drug therapy*
  • Humans
  • Hydrocortisone / blood
  • Hypothalamo-Hypophyseal System / drug effects
  • Infant
  • Male
  • Pituitary-Adrenal System / drug effects
  • Prednisolone / adverse effects*
  • Prednisolone / therapeutic use
  • Skin Neoplasms / congenital
  • Skin Neoplasms / drug therapy*

Substances

  • Glucocorticoids
  • Cosyntropin
  • Prednisolone
  • Hydrocortisone