Adrenal crises in children with adrenal insufficiency: epidemiology and risk factors View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2019-02-26

AUTHORS

Ori Eyal, Yair Levin, Asaf Oren, Amnon Zung, Marianna Rachmiel, Zohar Landau, Anita Schachter-Davidov, Anat Segev-Becker, Naomi Weintrob

ABSTRACT

The aim of the study was to assess the epidemiology and risk factors of adrenal crises (AC) in children with adrenal insufficiency (AI). Children diagnosed with AI between 1990 and 2017 at four Israeli pediatric endocrinology units were studied. Demographic and clinical data were retrieved retrospectively from their files. The study population consisted of 120 children (73 boys, 47 girls) and comprised 904 patient years. Median age at diagnosis was 0.3 years (0-17.5). Thirty-one AC events in 26 children occurred during the study period, accounting for a frequency of 3.4 crises/100 patient years. Fifty-two percent of AC events occurred at presentation. The significant risk factors for developing AC were the following: younger age at diagnosis (P = 0.003), primary AI vs. secondary AI (P = 0.016), specific diagnosis of autoimmune AI, adrenal hypoplasia congenita and salt wasting congenital adrenal hyperplasia (P < 0.001), mineralocorticoid treatment (P < 0.001), and recurrent hospital admissions (P > 0.001). After applying a stepwise logistic regression model, only the group of diagnoses, including salt wasting CAH, AHC, and Addison's disease, remained significant predictor of AC (OR 17.5, 95% CI 4.7-64.9, P < 0.001). There was no AC-associated mortality during the study period.Conclusions: Since significant percent of AC events occurred at presentation, measures to increase the awareness to signs and symptoms of AI among primary care physicians should be taken. Efforts to prevent AC should be focused on younger patients, especially those with primary AI. What Is Known: • Diagnosis and long-term management of pediatric patients with adrenal insufficiency (AI) remain a challenge. • Adrenal crises (AC) pose life-threatening emergencies in affected youngsters. Studies on the rate and risk factors of AC in children with AI are scarce, and they were done mainly on children with congenital adrenal hyperplasia (CAH). What Is New: • The rate of AC was relatively low and there was no AC-associated mortality during the study period. • Children with primary AI were at higher risk for AC than children with secondary AI. Specifically, children with salt wasting CAH, adrenal hypoplasia congenita, and Addison's disease at the highest risk. More... »

PAGES

1-8

References to SciGraph publications

  • 2015-09. An integrative view on sex differences in brain tumors in CELLULAR AND MOLECULAR LIFE SCIENCES
  • 2009-09. Neonatal screening for congenital adrenal hyperplasia in NATURE REVIEWS ENDOCRINOLOGY
  • Identifiers

    URI

    http://scigraph.springernature.com/pub.10.1007/s00431-019-03348-1

    DOI

    http://dx.doi.org/10.1007/s00431-019-03348-1

    DIMENSIONS

    https://app.dimensions.ai/details/publication/pub.1112397690

    PUBMED

    https://www.ncbi.nlm.nih.gov/pubmed/30806790


    Indexing Status Check whether this publication has been indexed by Scopus and Web Of Science using the SN Indexing Status Tool
    Incoming Citations Browse incoming citations for this publication using opencitations.net

    JSON-LD is the canonical representation for SciGraph data.

    TIP: You can open this SciGraph record using an external JSON-LD service: JSON-LD Playground Google SDTT

    [
      {
        "@context": "https://springernature.github.io/scigraph/jsonld/sgcontext.json", 
        "about": [
          {
            "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/1117", 
            "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
            "name": "Public Health and Health Services", 
            "type": "DefinedTerm"
          }, 
          {
            "id": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/11", 
            "inDefinedTermSet": "http://purl.org/au-research/vocabulary/anzsrc-for/2008/", 
            "name": "Medical and Health Sciences", 
            "type": "DefinedTerm"
          }
        ], 
        "author": [
          {
            "affiliation": {
              "alternateName": "Tel Aviv University", 
              "id": "https://www.grid.ac/institutes/grid.12136.37", 
              "name": [
                "Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children\u2019s Hospital, Tel-Aviv Sourasky Medical Center, 6 Weizmann St, 6423906, Tel Aviv, Israel", 
                "Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Eyal", 
            "givenName": "Ori", 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Tel Aviv University", 
              "id": "https://www.grid.ac/institutes/grid.12136.37", 
              "name": [
                "Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Levin", 
            "givenName": "Yair", 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Tel Aviv University", 
              "id": "https://www.grid.ac/institutes/grid.12136.37", 
              "name": [
                "Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children\u2019s Hospital, Tel-Aviv Sourasky Medical Center, 6 Weizmann St, 6423906, Tel Aviv, Israel", 
                "Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Oren", 
            "givenName": "Asaf", 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Hebrew University of Jerusalem", 
              "id": "https://www.grid.ac/institutes/grid.9619.7", 
              "name": [
                "Pediatric Endocrinology Unit, Kaplan Medical Center, Rehovot, Israel", 
                "The Hebrew University of Jerusalem, Jerusalem, Israel"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Zung", 
            "givenName": "Amnon", 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Assaf Harofeh Medical Center", 
              "id": "https://www.grid.ac/institutes/grid.413990.6", 
              "name": [
                "Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel", 
                "Pediatric Endocrinology Unit, Assaf Harofeh Medical Center, Zerifin, Israel"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Rachmiel", 
            "givenName": "Marianna", 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Wolfson Medical Center", 
              "id": "https://www.grid.ac/institutes/grid.414317.4", 
              "name": [
                "Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel", 
                "Pediatric Endocrinology Unit, Wolfson Medical Center, Holon, Israel"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Landau", 
            "givenName": "Zohar", 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Tel Aviv University", 
              "id": "https://www.grid.ac/institutes/grid.12136.37", 
              "name": [
                "Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children\u2019s Hospital, Tel-Aviv Sourasky Medical Center, 6 Weizmann St, 6423906, Tel Aviv, Israel", 
                "Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Schachter-Davidov", 
            "givenName": "Anita", 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Tel Aviv University", 
              "id": "https://www.grid.ac/institutes/grid.12136.37", 
              "name": [
                "Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children\u2019s Hospital, Tel-Aviv Sourasky Medical Center, 6 Weizmann St, 6423906, Tel Aviv, Israel", 
                "Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Segev-Becker", 
            "givenName": "Anat", 
            "type": "Person"
          }, 
          {
            "affiliation": {
              "alternateName": "Tel Aviv University", 
              "id": "https://www.grid.ac/institutes/grid.12136.37", 
              "name": [
                "Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children\u2019s Hospital, Tel-Aviv Sourasky Medical Center, 6 Weizmann St, 6423906, Tel Aviv, Israel", 
                "Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel"
              ], 
              "type": "Organization"
            }, 
            "familyName": "Weintrob", 
            "givenName": "Naomi", 
            "type": "Person"
          }
        ], 
        "citation": [
          {
            "id": "https://doi.org/10.1016/s0140-6736(03)13492-7", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1000863217"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1016/s0140-6736(03)13492-7", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1000863217"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1016/j.amjmed.2015.08.021", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1004714017"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1530/eje-12-0161", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1005034187"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00018-015-1930-2", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1009127895", 
              "https://doi.org/10.1007/s00018-015-1930-2"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1007/s00018-015-1930-2", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1009127895", 
              "https://doi.org/10.1007/s00018-015-1930-2"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1210/jc.2015-1710", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1011995472"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1530/eje.1.01911", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1012752320"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1055/s-0034-1395680", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1017029938"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1530/eje-15-0775", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1021035714"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1038/nrendo.2009.148", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1026461862", 
              "https://doi.org/10.1038/nrendo.2009.148"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "sg:pub.10.1038/nrendo.2009.148", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1026461862", 
              "https://doi.org/10.1038/nrendo.2009.148"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1159/000447946", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1032224402"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1016/s0140-6736(13)61684-0", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1038181570"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1530/eje-09-0884", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1041837051"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1111/cen.12865", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1042725494"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1530/eje-14-0824", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1044486865"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1016/s2213-8587(14)70142-1", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1045663018"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1155/2016/5748264", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1048447634"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1097/maj.0b013e3181db6b7a", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1049239727"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1097/maj.0b013e3181db6b7a", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1049239727"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1155/2013/482370", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1049866113"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1530/eje-09-0559", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1052093622"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1016/j.beem.2015.04.002", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1052606925"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1055/s-0035-1548817", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1057335911"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1055/s-0035-1548869", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1057335955"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1210/jc.2002-021433", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1064286392"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1210/jc.2004-0016", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1064287625"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1210/jc.2010-0982", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1064292231"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1210/jc.2011-0015", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1064292651"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1210/jc.2012-4059", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1064294049"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1210/jc.2014-3191", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1064295457"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1210/jcem.83.1.4496", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1064321324"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1542/peds.2005-1973", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1067824629"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1507/endocrj.ej16-0429", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1083750854"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1056/nejmcpc1616024", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1084149595"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1159/000479370", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1091605143"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1210/jc.2017-01928", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1092719937"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1159/000486393", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1101085325"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.4158/ep-2017-0132", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1101552878"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1210/jc.2018-00208", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1101712141"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1159/000481660", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1104430213"
            ], 
            "type": "CreativeWork"
          }, 
          {
            "id": "https://doi.org/10.1111/cen.13826", 
            "sameAs": [
              "https://app.dimensions.ai/details/publication/pub.1106022851"
            ], 
            "type": "CreativeWork"
          }
        ], 
        "datePublished": "2019-02-26", 
        "datePublishedReg": "2019-02-26", 
        "description": "The aim of the study was to assess the epidemiology and risk factors of adrenal crises (AC) in children with adrenal insufficiency (AI). Children diagnosed with AI between 1990 and 2017 at four Israeli pediatric endocrinology units were studied. Demographic and clinical data were retrieved retrospectively from their files. The study population consisted of 120 children (73 boys, 47 girls) and comprised 904 patient years. Median age at diagnosis was 0.3\u00a0years (0-17.5). Thirty-one AC events in 26 children occurred during the study period, accounting for a frequency of 3.4 crises/100 patient years. Fifty-two percent of AC events occurred at presentation. The significant risk factors for developing AC were the following: younger age at diagnosis (P\u2009=\u20090.003), primary AI vs. secondary AI (P\u2009=\u20090.016), specific diagnosis of autoimmune AI, adrenal hypoplasia congenita and salt wasting congenital adrenal hyperplasia (P\u2009<\u20090.001), mineralocorticoid treatment (P\u2009<\u20090.001), and recurrent hospital admissions (P\u2009>\u20090.001). After applying a stepwise logistic regression model, only the group of diagnoses, including salt wasting CAH, AHC, and Addison's disease, remained significant predictor of AC (OR 17.5, 95% CI 4.7-64.9, P\u2009<\u20090.001). There was no AC-associated mortality during the study period.Conclusions: Since significant percent of AC events occurred at presentation, measures to increase the awareness to signs and symptoms of AI among primary care physicians should be taken. Efforts to prevent AC should be focused on younger patients, especially those with primary AI. What Is Known: \u2022 Diagnosis and long-term management of pediatric patients with adrenal insufficiency (AI) remain a challenge. \u2022 Adrenal crises (AC) pose life-threatening emergencies in affected youngsters. Studies on the rate and risk factors of AC in children with AI are scarce, and they were done mainly on children with congenital adrenal hyperplasia (CAH). What Is New: \u2022 The rate of AC was relatively low and there was no AC-associated mortality during the study period. \u2022 Children with primary AI were at higher risk for AC than children with secondary AI. Specifically, children with salt wasting CAH, adrenal hypoplasia congenita, and Addison's disease at the highest risk.", 
        "genre": "research_article", 
        "id": "sg:pub.10.1007/s00431-019-03348-1", 
        "inLanguage": [
          "en"
        ], 
        "isAccessibleForFree": false, 
        "isPartOf": [
          {
            "id": "sg:journal.1017354", 
            "issn": [
              "0340-6199", 
              "1432-1076"
            ], 
            "name": "European Journal of Pediatrics", 
            "type": "Periodical"
          }, 
          {
            "issueNumber": "5", 
            "type": "PublicationIssue"
          }, 
          {
            "type": "PublicationVolume", 
            "volumeNumber": "178"
          }
        ], 
        "name": "Adrenal crises in children with adrenal insufficiency: epidemiology and risk factors", 
        "pagination": "1-8", 
        "productId": [
          {
            "name": "doi", 
            "type": "PropertyValue", 
            "value": [
              "10.1007/s00431-019-03348-1"
            ]
          }, 
          {
            "name": "dimensions_id", 
            "type": "PropertyValue", 
            "value": [
              "pub.1112397690"
            ]
          }, 
          {
            "name": "readcube_id", 
            "type": "PropertyValue", 
            "value": [
              "ecda5c286424cac06ccb88f9e4b05e6e457c82d9b9d717d55a20027867d6a2d1"
            ]
          }, 
          {
            "name": "nlm_unique_id", 
            "type": "PropertyValue", 
            "value": [
              "7603873"
            ]
          }, 
          {
            "name": "pubmed_id", 
            "type": "PropertyValue", 
            "value": [
              "30806790"
            ]
          }
        ], 
        "sameAs": [
          "https://doi.org/10.1007/s00431-019-03348-1", 
          "https://app.dimensions.ai/details/publication/pub.1112397690"
        ], 
        "sdDataset": "articles", 
        "sdDatePublished": "2019-04-16T06:21", 
        "sdLicense": "https://scigraph.springernature.com/explorer/license/", 
        "sdPublisher": {
          "name": "Springer Nature - SN SciGraph project", 
          "type": "Organization"
        }, 
        "sdSource": "s3://com-uberresearch-data-dimensions-target-20181106-alternative/cleanup/v134/2549eaecd7973599484d7c17b260dba0a4ecb94b/merge/v9/a6c9fde33151104705d4d7ff012ea9563521a3ce/jats-lookup/v90/0000000377_0000000377/records_106807_00000002.jsonl", 
        "type": "ScholarlyArticle", 
        "url": "https://link.springer.com/10.1007%2Fs00431-019-03348-1"
      }
    ]
     

    Download the RDF metadata as:  json-ld nt turtle xml License info

    HOW TO GET THIS DATA PROGRAMMATICALLY:

    JSON-LD is a popular format for linked data which is fully compatible with JSON.

    curl -H 'Accept: application/ld+json' 'https://scigraph.springernature.com/pub.10.1007/s00431-019-03348-1'

    N-Triples is a line-based linked data format ideal for batch operations.

    curl -H 'Accept: application/n-triples' 'https://scigraph.springernature.com/pub.10.1007/s00431-019-03348-1'

    Turtle is a human-readable linked data format.

    curl -H 'Accept: text/turtle' 'https://scigraph.springernature.com/pub.10.1007/s00431-019-03348-1'

    RDF/XML is a standard XML format for linked data.

    curl -H 'Accept: application/rdf+xml' 'https://scigraph.springernature.com/pub.10.1007/s00431-019-03348-1'


     

    This table displays all metadata directly associated to this object as RDF triples.

    248 TRIPLES      21 PREDICATES      67 URIs      20 LITERALS      9 BLANK NODES

    Subject Predicate Object
    1 sg:pub.10.1007/s00431-019-03348-1 schema:about anzsrc-for:11
    2 anzsrc-for:1117
    3 schema:author Ne6ed54d46a4d40739877bc8c6abae281
    4 schema:citation sg:pub.10.1007/s00018-015-1930-2
    5 sg:pub.10.1038/nrendo.2009.148
    6 https://doi.org/10.1016/j.amjmed.2015.08.021
    7 https://doi.org/10.1016/j.beem.2015.04.002
    8 https://doi.org/10.1016/s0140-6736(03)13492-7
    9 https://doi.org/10.1016/s0140-6736(13)61684-0
    10 https://doi.org/10.1016/s2213-8587(14)70142-1
    11 https://doi.org/10.1055/s-0034-1395680
    12 https://doi.org/10.1055/s-0035-1548817
    13 https://doi.org/10.1055/s-0035-1548869
    14 https://doi.org/10.1056/nejmcpc1616024
    15 https://doi.org/10.1097/maj.0b013e3181db6b7a
    16 https://doi.org/10.1111/cen.12865
    17 https://doi.org/10.1111/cen.13826
    18 https://doi.org/10.1155/2013/482370
    19 https://doi.org/10.1155/2016/5748264
    20 https://doi.org/10.1159/000447946
    21 https://doi.org/10.1159/000479370
    22 https://doi.org/10.1159/000481660
    23 https://doi.org/10.1159/000486393
    24 https://doi.org/10.1210/jc.2002-021433
    25 https://doi.org/10.1210/jc.2004-0016
    26 https://doi.org/10.1210/jc.2010-0982
    27 https://doi.org/10.1210/jc.2011-0015
    28 https://doi.org/10.1210/jc.2012-4059
    29 https://doi.org/10.1210/jc.2014-3191
    30 https://doi.org/10.1210/jc.2015-1710
    31 https://doi.org/10.1210/jc.2017-01928
    32 https://doi.org/10.1210/jc.2018-00208
    33 https://doi.org/10.1210/jcem.83.1.4496
    34 https://doi.org/10.1507/endocrj.ej16-0429
    35 https://doi.org/10.1530/eje-09-0559
    36 https://doi.org/10.1530/eje-09-0884
    37 https://doi.org/10.1530/eje-12-0161
    38 https://doi.org/10.1530/eje-14-0824
    39 https://doi.org/10.1530/eje-15-0775
    40 https://doi.org/10.1530/eje.1.01911
    41 https://doi.org/10.1542/peds.2005-1973
    42 https://doi.org/10.4158/ep-2017-0132
    43 schema:datePublished 2019-02-26
    44 schema:datePublishedReg 2019-02-26
    45 schema:description The aim of the study was to assess the epidemiology and risk factors of adrenal crises (AC) in children with adrenal insufficiency (AI). Children diagnosed with AI between 1990 and 2017 at four Israeli pediatric endocrinology units were studied. Demographic and clinical data were retrieved retrospectively from their files. The study population consisted of 120 children (73 boys, 47 girls) and comprised 904 patient years. Median age at diagnosis was 0.3 years (0-17.5). Thirty-one AC events in 26 children occurred during the study period, accounting for a frequency of 3.4 crises/100 patient years. Fifty-two percent of AC events occurred at presentation. The significant risk factors for developing AC were the following: younger age at diagnosis (P = 0.003), primary AI vs. secondary AI (P = 0.016), specific diagnosis of autoimmune AI, adrenal hypoplasia congenita and salt wasting congenital adrenal hyperplasia (P < 0.001), mineralocorticoid treatment (P < 0.001), and recurrent hospital admissions (P > 0.001). After applying a stepwise logistic regression model, only the group of diagnoses, including salt wasting CAH, AHC, and Addison's disease, remained significant predictor of AC (OR 17.5, 95% CI 4.7-64.9, P < 0.001). There was no AC-associated mortality during the study period.Conclusions: Since significant percent of AC events occurred at presentation, measures to increase the awareness to signs and symptoms of AI among primary care physicians should be taken. Efforts to prevent AC should be focused on younger patients, especially those with primary AI. What Is Known: • Diagnosis and long-term management of pediatric patients with adrenal insufficiency (AI) remain a challenge. • Adrenal crises (AC) pose life-threatening emergencies in affected youngsters. Studies on the rate and risk factors of AC in children with AI are scarce, and they were done mainly on children with congenital adrenal hyperplasia (CAH). What Is New: • The rate of AC was relatively low and there was no AC-associated mortality during the study period. • Children with primary AI were at higher risk for AC than children with secondary AI. Specifically, children with salt wasting CAH, adrenal hypoplasia congenita, and Addison's disease at the highest risk.
    46 schema:genre research_article
    47 schema:inLanguage en
    48 schema:isAccessibleForFree false
    49 schema:isPartOf N70ac3ebc26594cd4af76bb375e72c64b
    50 Nf910558c277c4da9afaf3b852471a085
    51 sg:journal.1017354
    52 schema:name Adrenal crises in children with adrenal insufficiency: epidemiology and risk factors
    53 schema:pagination 1-8
    54 schema:productId N0bf573f2dca24effa069152170fa7d18
    55 N6a8f2faf2d294c50be02cf37f9364ae8
    56 Nb1d547b0d8ba45b48587bc9acdea77e8
    57 Nb7eece5f9f974e8a972086a2bef81ef2
    58 Nde961a7a21aa450e894564bf13411145
    59 schema:sameAs https://app.dimensions.ai/details/publication/pub.1112397690
    60 https://doi.org/10.1007/s00431-019-03348-1
    61 schema:sdDatePublished 2019-04-16T06:21
    62 schema:sdLicense https://scigraph.springernature.com/explorer/license/
    63 schema:sdPublisher N5fff7a16ae9e4274a607f5b011b1bb95
    64 schema:url https://link.springer.com/10.1007%2Fs00431-019-03348-1
    65 sgo:license sg:explorer/license/
    66 sgo:sdDataset articles
    67 rdf:type schema:ScholarlyArticle
    68 N05c0abdfa47e4b95b02413f77bc63d8e schema:affiliation https://www.grid.ac/institutes/grid.414317.4
    69 schema:familyName Landau
    70 schema:givenName Zohar
    71 rdf:type schema:Person
    72 N0bf573f2dca24effa069152170fa7d18 schema:name dimensions_id
    73 schema:value pub.1112397690
    74 rdf:type schema:PropertyValue
    75 N0f94cd29b89a4abb9748f56ad9fe24a7 schema:affiliation https://www.grid.ac/institutes/grid.9619.7
    76 schema:familyName Zung
    77 schema:givenName Amnon
    78 rdf:type schema:Person
    79 N139babd2dc2b46b2926a9dbf3a813188 rdf:first Nb2704c8664e442f780c7ca5c30e7b167
    80 rdf:rest N5465d98723694c7ba8d209d576347edb
    81 N1643c49390ee43d9ad8a015b130960e8 schema:affiliation https://www.grid.ac/institutes/grid.12136.37
    82 schema:familyName Oren
    83 schema:givenName Asaf
    84 rdf:type schema:Person
    85 N401baa87d8c74595aba32882d479d88d rdf:first N1643c49390ee43d9ad8a015b130960e8
    86 rdf:rest Nea36b96e71f8450aa6dc68c28cf62f25
    87 N5465d98723694c7ba8d209d576347edb rdf:first Nd61f46682afe4af7a108bedb7ac84ea8
    88 rdf:rest Nc9f359dd4e3548eaa6b5a775e0b898f5
    89 N5979742edc8646419e716f9ec1192cd7 schema:affiliation https://www.grid.ac/institutes/grid.413990.6
    90 schema:familyName Rachmiel
    91 schema:givenName Marianna
    92 rdf:type schema:Person
    93 N5fff7a16ae9e4274a607f5b011b1bb95 schema:name Springer Nature - SN SciGraph project
    94 rdf:type schema:Organization
    95 N6a8f2faf2d294c50be02cf37f9364ae8 schema:name nlm_unique_id
    96 schema:value 7603873
    97 rdf:type schema:PropertyValue
    98 N70ac3ebc26594cd4af76bb375e72c64b schema:volumeNumber 178
    99 rdf:type schema:PublicationVolume
    100 N8a56d0a5cb664994b28cb3188ac91cc7 rdf:first N05c0abdfa47e4b95b02413f77bc63d8e
    101 rdf:rest N139babd2dc2b46b2926a9dbf3a813188
    102 Nb1d547b0d8ba45b48587bc9acdea77e8 schema:name doi
    103 schema:value 10.1007/s00431-019-03348-1
    104 rdf:type schema:PropertyValue
    105 Nb2704c8664e442f780c7ca5c30e7b167 schema:affiliation https://www.grid.ac/institutes/grid.12136.37
    106 schema:familyName Schachter-Davidov
    107 schema:givenName Anita
    108 rdf:type schema:Person
    109 Nb5644d953eae4fa78ea0a598ff976e4c schema:affiliation https://www.grid.ac/institutes/grid.12136.37
    110 schema:familyName Levin
    111 schema:givenName Yair
    112 rdf:type schema:Person
    113 Nb7eece5f9f974e8a972086a2bef81ef2 schema:name pubmed_id
    114 schema:value 30806790
    115 rdf:type schema:PropertyValue
    116 Nc9f359dd4e3548eaa6b5a775e0b898f5 rdf:first Ndc8da212245449ed8b596a4f271ed567
    117 rdf:rest rdf:nil
    118 Nd1011979fc2b445f93c44fa73c63efa6 rdf:first N5979742edc8646419e716f9ec1192cd7
    119 rdf:rest N8a56d0a5cb664994b28cb3188ac91cc7
    120 Nd61f46682afe4af7a108bedb7ac84ea8 schema:affiliation https://www.grid.ac/institutes/grid.12136.37
    121 schema:familyName Segev-Becker
    122 schema:givenName Anat
    123 rdf:type schema:Person
    124 Ndc8da212245449ed8b596a4f271ed567 schema:affiliation https://www.grid.ac/institutes/grid.12136.37
    125 schema:familyName Weintrob
    126 schema:givenName Naomi
    127 rdf:type schema:Person
    128 Nde961a7a21aa450e894564bf13411145 schema:name readcube_id
    129 schema:value ecda5c286424cac06ccb88f9e4b05e6e457c82d9b9d717d55a20027867d6a2d1
    130 rdf:type schema:PropertyValue
    131 Ne6ed54d46a4d40739877bc8c6abae281 rdf:first Ne72fa5231e1b48d6a1db3fbed789613a
    132 rdf:rest Ne800df02b81e464fa5515aeb255efac7
    133 Ne72fa5231e1b48d6a1db3fbed789613a schema:affiliation https://www.grid.ac/institutes/grid.12136.37
    134 schema:familyName Eyal
    135 schema:givenName Ori
    136 rdf:type schema:Person
    137 Ne800df02b81e464fa5515aeb255efac7 rdf:first Nb5644d953eae4fa78ea0a598ff976e4c
    138 rdf:rest N401baa87d8c74595aba32882d479d88d
    139 Nea36b96e71f8450aa6dc68c28cf62f25 rdf:first N0f94cd29b89a4abb9748f56ad9fe24a7
    140 rdf:rest Nd1011979fc2b445f93c44fa73c63efa6
    141 Nf910558c277c4da9afaf3b852471a085 schema:issueNumber 5
    142 rdf:type schema:PublicationIssue
    143 anzsrc-for:11 schema:inDefinedTermSet anzsrc-for:
    144 schema:name Medical and Health Sciences
    145 rdf:type schema:DefinedTerm
    146 anzsrc-for:1117 schema:inDefinedTermSet anzsrc-for:
    147 schema:name Public Health and Health Services
    148 rdf:type schema:DefinedTerm
    149 sg:journal.1017354 schema:issn 0340-6199
    150 1432-1076
    151 schema:name European Journal of Pediatrics
    152 rdf:type schema:Periodical
    153 sg:pub.10.1007/s00018-015-1930-2 schema:sameAs https://app.dimensions.ai/details/publication/pub.1009127895
    154 https://doi.org/10.1007/s00018-015-1930-2
    155 rdf:type schema:CreativeWork
    156 sg:pub.10.1038/nrendo.2009.148 schema:sameAs https://app.dimensions.ai/details/publication/pub.1026461862
    157 https://doi.org/10.1038/nrendo.2009.148
    158 rdf:type schema:CreativeWork
    159 https://doi.org/10.1016/j.amjmed.2015.08.021 schema:sameAs https://app.dimensions.ai/details/publication/pub.1004714017
    160 rdf:type schema:CreativeWork
    161 https://doi.org/10.1016/j.beem.2015.04.002 schema:sameAs https://app.dimensions.ai/details/publication/pub.1052606925
    162 rdf:type schema:CreativeWork
    163 https://doi.org/10.1016/s0140-6736(03)13492-7 schema:sameAs https://app.dimensions.ai/details/publication/pub.1000863217
    164 rdf:type schema:CreativeWork
    165 https://doi.org/10.1016/s0140-6736(13)61684-0 schema:sameAs https://app.dimensions.ai/details/publication/pub.1038181570
    166 rdf:type schema:CreativeWork
    167 https://doi.org/10.1016/s2213-8587(14)70142-1 schema:sameAs https://app.dimensions.ai/details/publication/pub.1045663018
    168 rdf:type schema:CreativeWork
    169 https://doi.org/10.1055/s-0034-1395680 schema:sameAs https://app.dimensions.ai/details/publication/pub.1017029938
    170 rdf:type schema:CreativeWork
    171 https://doi.org/10.1055/s-0035-1548817 schema:sameAs https://app.dimensions.ai/details/publication/pub.1057335911
    172 rdf:type schema:CreativeWork
    173 https://doi.org/10.1055/s-0035-1548869 schema:sameAs https://app.dimensions.ai/details/publication/pub.1057335955
    174 rdf:type schema:CreativeWork
    175 https://doi.org/10.1056/nejmcpc1616024 schema:sameAs https://app.dimensions.ai/details/publication/pub.1084149595
    176 rdf:type schema:CreativeWork
    177 https://doi.org/10.1097/maj.0b013e3181db6b7a schema:sameAs https://app.dimensions.ai/details/publication/pub.1049239727
    178 rdf:type schema:CreativeWork
    179 https://doi.org/10.1111/cen.12865 schema:sameAs https://app.dimensions.ai/details/publication/pub.1042725494
    180 rdf:type schema:CreativeWork
    181 https://doi.org/10.1111/cen.13826 schema:sameAs https://app.dimensions.ai/details/publication/pub.1106022851
    182 rdf:type schema:CreativeWork
    183 https://doi.org/10.1155/2013/482370 schema:sameAs https://app.dimensions.ai/details/publication/pub.1049866113
    184 rdf:type schema:CreativeWork
    185 https://doi.org/10.1155/2016/5748264 schema:sameAs https://app.dimensions.ai/details/publication/pub.1048447634
    186 rdf:type schema:CreativeWork
    187 https://doi.org/10.1159/000447946 schema:sameAs https://app.dimensions.ai/details/publication/pub.1032224402
    188 rdf:type schema:CreativeWork
    189 https://doi.org/10.1159/000479370 schema:sameAs https://app.dimensions.ai/details/publication/pub.1091605143
    190 rdf:type schema:CreativeWork
    191 https://doi.org/10.1159/000481660 schema:sameAs https://app.dimensions.ai/details/publication/pub.1104430213
    192 rdf:type schema:CreativeWork
    193 https://doi.org/10.1159/000486393 schema:sameAs https://app.dimensions.ai/details/publication/pub.1101085325
    194 rdf:type schema:CreativeWork
    195 https://doi.org/10.1210/jc.2002-021433 schema:sameAs https://app.dimensions.ai/details/publication/pub.1064286392
    196 rdf:type schema:CreativeWork
    197 https://doi.org/10.1210/jc.2004-0016 schema:sameAs https://app.dimensions.ai/details/publication/pub.1064287625
    198 rdf:type schema:CreativeWork
    199 https://doi.org/10.1210/jc.2010-0982 schema:sameAs https://app.dimensions.ai/details/publication/pub.1064292231
    200 rdf:type schema:CreativeWork
    201 https://doi.org/10.1210/jc.2011-0015 schema:sameAs https://app.dimensions.ai/details/publication/pub.1064292651
    202 rdf:type schema:CreativeWork
    203 https://doi.org/10.1210/jc.2012-4059 schema:sameAs https://app.dimensions.ai/details/publication/pub.1064294049
    204 rdf:type schema:CreativeWork
    205 https://doi.org/10.1210/jc.2014-3191 schema:sameAs https://app.dimensions.ai/details/publication/pub.1064295457
    206 rdf:type schema:CreativeWork
    207 https://doi.org/10.1210/jc.2015-1710 schema:sameAs https://app.dimensions.ai/details/publication/pub.1011995472
    208 rdf:type schema:CreativeWork
    209 https://doi.org/10.1210/jc.2017-01928 schema:sameAs https://app.dimensions.ai/details/publication/pub.1092719937
    210 rdf:type schema:CreativeWork
    211 https://doi.org/10.1210/jc.2018-00208 schema:sameAs https://app.dimensions.ai/details/publication/pub.1101712141
    212 rdf:type schema:CreativeWork
    213 https://doi.org/10.1210/jcem.83.1.4496 schema:sameAs https://app.dimensions.ai/details/publication/pub.1064321324
    214 rdf:type schema:CreativeWork
    215 https://doi.org/10.1507/endocrj.ej16-0429 schema:sameAs https://app.dimensions.ai/details/publication/pub.1083750854
    216 rdf:type schema:CreativeWork
    217 https://doi.org/10.1530/eje-09-0559 schema:sameAs https://app.dimensions.ai/details/publication/pub.1052093622
    218 rdf:type schema:CreativeWork
    219 https://doi.org/10.1530/eje-09-0884 schema:sameAs https://app.dimensions.ai/details/publication/pub.1041837051
    220 rdf:type schema:CreativeWork
    221 https://doi.org/10.1530/eje-12-0161 schema:sameAs https://app.dimensions.ai/details/publication/pub.1005034187
    222 rdf:type schema:CreativeWork
    223 https://doi.org/10.1530/eje-14-0824 schema:sameAs https://app.dimensions.ai/details/publication/pub.1044486865
    224 rdf:type schema:CreativeWork
    225 https://doi.org/10.1530/eje-15-0775 schema:sameAs https://app.dimensions.ai/details/publication/pub.1021035714
    226 rdf:type schema:CreativeWork
    227 https://doi.org/10.1530/eje.1.01911 schema:sameAs https://app.dimensions.ai/details/publication/pub.1012752320
    228 rdf:type schema:CreativeWork
    229 https://doi.org/10.1542/peds.2005-1973 schema:sameAs https://app.dimensions.ai/details/publication/pub.1067824629
    230 rdf:type schema:CreativeWork
    231 https://doi.org/10.4158/ep-2017-0132 schema:sameAs https://app.dimensions.ai/details/publication/pub.1101552878
    232 rdf:type schema:CreativeWork
    233 https://www.grid.ac/institutes/grid.12136.37 schema:alternateName Tel Aviv University
    234 schema:name Pediatric Endocrinology and Diabetes Unit, Dana-Dwek Children’s Hospital, Tel-Aviv Sourasky Medical Center, 6 Weizmann St, 6423906, Tel Aviv, Israel
    235 Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
    236 rdf:type schema:Organization
    237 https://www.grid.ac/institutes/grid.413990.6 schema:alternateName Assaf Harofeh Medical Center
    238 schema:name Pediatric Endocrinology Unit, Assaf Harofeh Medical Center, Zerifin, Israel
    239 Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
    240 rdf:type schema:Organization
    241 https://www.grid.ac/institutes/grid.414317.4 schema:alternateName Wolfson Medical Center
    242 schema:name Pediatric Endocrinology Unit, Wolfson Medical Center, Holon, Israel
    243 Sackler School of Medicine, Tel-Aviv University, Tel Aviv, Israel
    244 rdf:type schema:Organization
    245 https://www.grid.ac/institutes/grid.9619.7 schema:alternateName Hebrew University of Jerusalem
    246 schema:name Pediatric Endocrinology Unit, Kaplan Medical Center, Rehovot, Israel
    247 The Hebrew University of Jerusalem, Jerusalem, Israel
    248 rdf:type schema:Organization
     




    Preview window. Press ESC to close (or click here)


    ...