medigraphic.com
ISSN 2500-7106 (Digital)
ISSN 0123-2576 (Impreso)
Medicina & Laboratorio

2013, Número 03-04

<< Anterior Siguiente >>

Medicina & Laboratorio 2013; 19 (03-04)


Evaluación de la función del eje hipotálamohipófisis- adrenal en niños tratados con esteroides

Vélez PA, Balthazar GV, Campuzano MG

Idioma: Español
Referencias bibliográficas: 50
Paginas: 111-125
Archivo PDF: 595.16 Kb.


RESUMEN

El uso frecuente de medicamentos esteroideos constituye un riesgo de supresión del eje hipotálamo-hipófisis-adrenal, en particular si el tratamiento se usa por más de cuatro semanas. El retiro planeado del medicamento y la evaluación oportuna mediante la prueba corta de estimulación con hormona adrenocorticotrópica permiten identificar los niños en riesgo de presentar una crisis o una insuficiencia adrenal, como también establecer la necesidad de suplementar a los pacientes con esteroides durante situaciones de estrés. En este artículo de revisión se describen los efectos de los esteroides sobre el eje hipotálamo-hipófisis-adrenal en pacientes pediátricos, los esquemas de retiro gradual de los esteroides y las pruebas para evaluar la función del eje hipotálamo-hipófisis-adrenal en dichos pacientes.


REFERENCIAS (EN ESTE ARTÍCULO)

  1. Richter B, Neises G, Clar C. Glucocorticoid withdrawal schemes in chronic medical disorders. A systematic review. Endocrinol Metab Clin North Am 2002; 31: 751-778.

  2. Stewart PM, Krone NP. The adrenal cortex. In: Melmed S, Polonski KS, Larsen PR, Kronenberg HN, eds. Williams textbook of Endocrinology (ed 12). Philadelphia: Saunders Elsevier; 2011.

  3. Arango C, Campuzano G, Latorre G. Pruebas dinámicas en endocrinología: insuficiencia adrenal. Medicina & Laboratorio 2009; 15: 211-232.

  4. Alves C, Robazzi TC, Mendonca M. Withdrawal from glucocorticosteroid therapy: clinical practice recommendations. J Pediatr (Rio J) 2008; 84: 192-202.

  5. Arafah BM. Hypothalamic pituitary adrenal function during critical illness: limitations of current assessment methods. J Clin Endocrinol Metab 2006; 91: 3725-3745.

  6. Serra HA, Roganovich JM, Rizzo LFL. Glucocorticoides: paradigma de medicina traslacional. De lo molecular al uso clínico. Medicina (B Aires) 2012; 72: 158-170.

  7. Williams LC, Nesbitt LT, Jr. Update on systemic glucocorticosteroids in dermatology. Dermatol Clin 2001; 19: 63-77.

  8. Schacke H, Docke WD, Asadullah K. Mechanisms involved in the side effects of glucocorticoids. Pharmacol Ther 2002; 96: 23-43.

  9. Annett RD, Stansbury K, Kelly HW, Strunk RC. Association of hypothalamic-pituitary-adrenal axis function with neuropsychological performance in children with mild/moderate asthma. Child Neuropsychol 2005; 11: 333-348.

  10. Romanholi D, Salgado LR. Síndrome de Cushing exógena e retirada de glicocorticóides. Arq Bras Endocrinol Metab 2007; 51: 1280-1292.

  11. Bermúdez de la Vega JA, Rivas F, Sánchez del Pozo J, Gutierrez A. Sociedad Española de Endocrinología Pediátrica. Insuficiencia suprarrenal. Supresión del tratamiento corticoide. http://www.seep.es/privado/ documentos/consenso/cap20.pdf Consultado en noviembre de 2012.

  12. Zollner EW. Hypothalamic-pituitary-adrenal axis suppression in asthmatic children on inhaled corticosteroids: part 1. Which test should be used? Pediatr Allergy Immunol 2007; 18: 401-409.

  13. Trence DL. Management of patients on chronic glucocorticoid therapy: an endocrine perspective. Prim Care 2003; 30: 593-605.

  14. Huber BM, Bolt IB, Sauvain MJ, Fluck CE. Adrenal insufficiency after glucocorticoid withdrawal in children with rheumatic diseases. Acta Paediatr 2010; 99: 1889-1893.

  15. Vijayaraghavan S, Linder B. Special risks and management requirements in children receiving chronic steroid therapy. Pediatr Rev 1996; 17: 45-46.

  16. Aulakh R, Singh S. Strategies for minimizing corticosteroid toxicity: a review. Indian J Pediatr 2008; 75: 1067-1073.

  17. Silva IN, Cunha CF, Finch FL, Colosimo EA. [Evaluation of hypothalamic-pituitary-adrenal axis recovery after corticotherapy by using basal cortisol secretion]. Arq Bras Endocrinol Metabol 2006; 50: 118-124.

  18. Gulliver T, Eid N. Effects of glucocorticoids on the hypothalamic-pituitary-adrenal axis in children and adults. Immunol Allergy Clin North Am 2005; 25: 541- 555, vii.

  19. Todd GR, Acerini CL, Ross-Russell R, Zahra S, Warner JT, McCance D. Survey of adrenal crisis associated with inhaled corticosteroids in the United Kingdom. Arch Dis Child 2002; 87: 457-461.

  20. Ahmet A, Kim H, Spier S. Adrenal suppression: A practical guide to the screening and management of this under-recognized complication of inhaled corticosteroid therapy. Allergy Asthma Clin Immunol 2011; 7: 13.

  21. Brodlie M, McMurray A, Crofton PM, Bath L, Cunningham S. Strategies to screen for adrenal suppression in children with asthma should take account of compliance with inhaled corticosteroids. Eur J Pediatr 2007; 166: 493-494.

  22. Zollner EW. Hypothalamic-pituitary-adrenal axis suppression in asthmatic children on inhaled corticosteroids (Part 2)--the risk as determined by gold standard adrenal function tests: a systematic review. Pediatr Allergy Immunol 2007; 18: 469-474.

  23. Rix M, Birkebaek NH, Rosthoj S, Clausen N. Clinical impact of corticosteroid-induced adrenal suppression during treatment for acute lymphoblastic leukemia in children: a prospective observational study using the low-dose adrenocorticotropin test. J Pediatr 2005; 147: 645-650.

  24. Milinarsky A, Fischer S, Giadrosich V, Lezana V, Torres MT. Efecto de dosis altas de budesonida y función suprarrenal de niños asmáticos severos. Rev Med Chile 2006; 134: 60-64.

  25. Abeyagunawardena AS, Hindmarsh P, Trompeter RS. Adrenocortical suppression increases the risk of relapse in nephrotic syndrome. Arch Dis Child 2007; 92: 585-588.

  26. Einaudi S, Bertorello N, Masera N, Farinasso L, Barisone E, Rizzari C, et al. Adrenal axis function after high-dose steroid therapy for childhood acute lymphoblastic leukemia. Pediatr Blood Cancer 2008; 50: 537-541.

  27. Gupta P, Bhatia V. Corticosteroid physiology and principles of therapy. Indian J Pediatr 2008; 75: 1039- 1044.

  28. Maguire AM, Biesheuvel CJ, Ambler GR, Moore B, McLean M, Cowell CT. Evaluation of adrenal function using the human corticotrophin-releasing hormone test, low dose Synacthen test and 9am cortisol level in children and adolescents with central adrenal insufficiency. Clin Endocrinol (Oxf) 2008; 68: 683-691.

  29. Axelrod L. Perioperative management of patients treated with glucocorticoids. Endocrinol Metab Clin North Am 2003; 32: 367-383.

  30. Arlt W, Allolio B. Adrenal insufficiency. Lancet 2003; 361: 1881-1893.

  31. Brinn M, Hillenbrand K. Long-term corticosteroid use. Pediatr Rev 2009; 30: 497-498.

  32. Reimondo G, Bovio S, Allasino B, Terzolo M, Angeli A. Secondary hypoadrenalism. Pituitary 2008; 11: 147-154.

  33. Winter WE. Laboratory approaches to disease of the adrenal cortex & adrenal medulla. In: Jialal I, Winter WE, Chan DW, eds. Handbook of diagnostic endocrinology. Washington: AACC Press; 1999.

  34. Zollner EW, Lombard C, Galal U, Hough S, Irusen E, Weinberg E. Hypothalamic-pituitary-adrenal axis suppression in asthmatic children on inhaled and nasal corticosteroids: is the early-morning serum adrenocorticotropic hormone (ACTH) a useful screening test? Pediatr Allergy Immunol 2011; 22: 614-620.

  35. Clark L, Preissig C, Rigby MR, Bowyer F. Endocrine issues in the pediatric intensive care unit. Pediatr Clin North Am 2008; 55: 805-833, xiii.

  36. Einaudi S, Bondone C. The effects of head trauma on hypothalamic-pituitary function in children and adolescents. Curr Opin Pediatr 2007; 19: 465-470.

  37. Green ML, Koch J. Adrenocortical function in the postoperative pediatric cardiac surgical patient. Curr Opin Pediatr 2012; 24: 285-290.

  38. Marik PE, Pastores SM, Annane D, Meduri GU, Sprung CL, Arlt W, et al. Recommendations for the diagnosis and management of corticosteroid insufficiency in critically ill adult patients: consensus statements from an international task force by the American College of Critical Care Medicine. Crit Care Med 2008; 36: 1937-1949.

  39. Garcia X, Bhutta AT, Dyamenahalli U, Imamura M, Jaquiss RD, Prodhan P. Adrenal insufficiency in hemodynamically unstable neonates after open-heart surgery. Congenit Heart Dis 2010; 5: 422-429.

  40. Groschl M. Current status of salivary hormone analysis. Clin Chem 2008; 54: 1759-1769.

  41. Aziz DC. Use and interpretation of tests in endocrinology. United States of America: Specialty Laboratories; 1997.

  42. Gordijn MS, Gemke RJ, van Dalen EC, Rotteveel J, Kaspers GJ. Hypothalamic-pituitary-adrenal (HPA) axis suppression after treatment with glucocorticoid therapy for childhood acute lymphoblastic leukaemia. Cochrane Database Syst Rev 2012; 5: CD008727.

  43. Oelkers W. The role of high- and low-dose corticotropin tests in the diagnosis of secondary adrenal insufficiency. Eur J Endocrinol 1998; 139: 567-570.

  44. O’Grady MJ, Hensey C, Fallon M, Hoey H, Murphy N, Costigan C, et al. Lack of sensitivity of the 1-mug lowdose ACTH stimulation test in a paediatric population with suboptimal cortisol responses to insulin-induced hypoglycaemia. Clin Endocrinol (Oxf) 2013; 78: 73-78.

  45. Tordjman K, Jaffe A, Trostanetsky Y, Greenman Y, Limor R, Stern N. Low-dose (1 microgram) adrenocorticotrophin (ACTH) stimulation as a screening test for impaired hypothalamo-pituitary-adrenal axis function: sensitivity, specificity and accuracy in comparison with the high-dose (250 microgram) test. Clin Endocrinol (Oxf) 2000; 52: 633-640.

  46. Dickstein G. High-dose and low-dose cosyntropin stimulation tests for diagnosis of adrenal insufficiency. Ann Intern Med 2004; 140: 312-313; author reply 313-314.

  47. Suliman AM, Smith TP, Labib M, Fiad TM, McKenna TJ. The low-dose ACTH test does not provide a useful assessment of the hypothalamic-pituitary-adrenal axis in secondary adrenal insufficiency. Clin Endocrinol (Oxf) 2002; 56: 533-539.

  48. Gupta A, Cheetham T, Jaffray C, Ullman D, Gibb I, Spencer DA. Repeatability of the low-dose ACTH test in asthmatic children on inhaled corticosteroids. Acta Paediatr 2009; 98: 1945-1949.

  49. Neary N, Nieman L. Adrenal insufficiency: etiology, diagnosis and treatment. Curr Opin Endocrinol Diabetes Obes 2010; 17: 217-223.

  50. Cemeroglu AP, Kleis L, Postellon DC, Wood MA. Comparison of low-dose and high-dose cosyntropin stimulation testing in children. Pediatr Int 2011; 53: 175-180.




2020     |     www.medigraphic.com