Journal of Pediatric Nursing
Volume 25, Issue 1 , Pages 18-24 , February 2010

Hypoglycemia During Acute Illness in Children With Classic Congenital Adrenal Hyperplasia

Data from this paper was presented at the International Congress of Endocrinology (Lisbon, Portugal in September 2004) and the Pediatric Endocrine Nurses Society Conference (New Orleans, LA in May 2005).

  • Margaret F. Keil, MS, CRNP

      Affiliations

    • Reproductive Medicine and Biology Branch, National Institutes of Health, Bethesda, MD
    • Corresponding Author InformationCorresponding author: Margaret Keil, MS, CRNP.
    • ,
  • Charlotte Bosmans, BS, RN

      Affiliations

    • National Institute of Child Health and Human Development, The National Institutes of Health Clinical Center, National Institutes of Health, Bethesda, MD
    • ,
  • Carol Van Ryzin, MS, CRNP

      Affiliations

    • Reproductive Medicine and Biology Branch, National Institutes of Health, Bethesda, MD
    • National Institute of Child Health and Human Development, The National Institutes of Health Clinical Center, National Institutes of Health, Bethesda, MD
    • ,
  • Deborah P. Merke, MD, MS

      Affiliations

    • Reproductive Medicine and Biology Branch, National Institutes of Health, Bethesda, MD
    • National Institute of Child Health and Human Development, The National Institutes of Health Clinical Center, National Institutes of Health, Bethesda, MD
    • Commissioned Officers in the United States Public Health Service.

References 

  1. Bennish ML, Azad AK, Rahman O, Phillips RE. Hypoglycemia during diarrhea in childhood. Prevalence, pathophysiology, and outcome. New England Journal of Medicine. 1990;322:1357–1363
  2. Daral TS, Singh HP, Sachdev HP, Mohan M, Mathur M, Bhargava SK. Acute dehydrating diarrhea. Clinical profile in neonates and young infants. Indian Pediatrics. 1985;22:333–338
  3. Donaldson MD, Thomas PH, Love JG, Murray GD, McNinch AW, Savage DC. Presentation, acute illness, and learning difficulties in salt wasting 21-hydroxylase deficiency. Archives of Disease in Childhood. 1994;70:214–218
  4. Glyn-Jones R. Blood sugar in infantile gastro-enteritis. South African Medical Journal. 1975;49:1474–1476
  5. Jaaskelainen , Voutilainen R. Long-term outcome of classical 21-hydroxylase deficiency: diagnosis, complications and quality of life. Acta Paediatrica. 2000;89:183–187
  6. Jackson L, Williams FL, Burchell A, Coughtrie MW, Hume R. Plasma catecholamines and the counterregulatory responses to hypoglycemia in infants: a critical role for epinephrine and cortisol. Journal of Clinical Endocrinology and Metabolism. 2004;89:6251–6256
  7. Mackinnon J, Grant DB. Hypoglycaemia in congenital adrenal hyperplasia. Archives of Disease in Childhood. 1977;52:591–593
  8. Merke DP, Chrousos GP, Eisenhofer G, Weise M, Keil MF, Rogol AD, et al. Adrenomedullary dysplasia and hypofunction in patients with classic 21-hydroxylase deficiency. New England Journal of Medicine. 2000;343:1362–1368
  9. New MI, Gertner JM, Speiser PW, del Balzo P. Growth and final height in classical and nonclassical 21-hydroxylase deficiency. Acta Paediatrica Japonica. 1988;30(Suppl.):79–88
  10. Pinto G, Tardy V, Trivin C, Thalassinos C, Lortat-Jacob S, Nihoul-Fekete C, et al. Follow-up of 68 children with congenital adrenal hyperplasia due to 21-hydroxylase deficiency: relevance of genotype for management. Journal of Clinical Endocrinology and Metabolism. 2003;88:2624–2633
  11. Rasat R, Espiner EA, Abbott GD. Growth patterns and outcomes in congenital adrenal hyperplasia; effect of chronic treatment regimens. New Zealand Medical Journal. 1995;108:311–314
  12. Reid S, McQuillan S, Losek J. Hypoglycemia complicating dehydration due to acute gastroenteritis. Clinical Pediatrics (Phila). 2003;42:641–646
  13. Shamoon H, Hendler R, Sherwin RS. Synergistic interactions among antiinsulin hormones in the pathogenesis of stress hyperglycemia in humans. Journal of Clinical Endocrinology and Metabolism. 1981;52:1235–1241
  14. Soliman AT, AlLamki M, AlSalmi I, Asfour M. Congenital adrenal hyperplasia complicated by central precocious puberty: linear growth during infancy and treatment with gonadotropin-releasing hormone analog. Metabolism. 1997;46:513–517
  15. Weise M, Drinkard B, Mehlinger SL, Holzer SM, Eisenhofer G, Charmandari E, et al. Stress dose of hydrocortisone is not beneficial in patients with classic congenital adrenal hyperplasia undergoing short-term, high-intensity exercise. Journal of Clinical Endocrinology and Metabolism. 2004;89:3679–3684
  16. Young MC, Hughes IA. Response to treatment of congenital adrenal hyperplasia in infancy. Archives of Disease in Childhood. 1990;65:441–444

 This study was supported in part by the intramural program of NICHD, NIH and by the Congenital Adrenal hyperplasia Research, Education and Support (CARES) Foundation.

 No commercial financial support to declare.

PII: S0882-5963(08)00261-3

doi: 10.1016/j.pedn.2008.06.003

Journal of Pediatric Nursing
Volume 25, Issue 1 , Pages 18-24 , February 2010

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