Akyürek Nesibe, Selver Eklioğlu Beray, Binay Çiğdem
Başkent University Faculty of Medicine, Department of Pediatric Endocrinology, Konya, Turkey
Necmettin Erbakan University Faculty of Medicine, Department of Pediatric Endocrinology, Konya, Turkey
J Clin Res Pediatr Endocrinol. 2025 Jan 10;17(Suppl 1):44-53. doi: 10.4274/jcrpe.galenos.2024.2024-6-1-S. Epub 2024 Dec 23.
Adrenal insufficiency (AI) is a life-threatening disorder. Defects at any level of the hypothalamic-pituitary-adrenal axis can impair adrenal function. It is difficult to make a diagnosis of AI in the newborn because during the neonatal period clinical findings are not specific and range from insidious, nonspecific complaints to circulatorycollapse due to hypovolemic shock. Another condition when is difficult to make a diagnosis of AI is in critically ill patients. There is no consensus on which patients to test for AI, which tests to use and how to interpret them. In this evidence-based review we aim to provideinformation for the evaluation of adrenal function results and findings in both the neonatal period and critical illness in childhood and adolescence.
肾上腺功能不全(AI)是一种危及生命的疾病。下丘脑-垂体-肾上腺轴任何水平的缺陷都可能损害肾上腺功能。新生儿期很难诊断AI,因为在新生儿期临床表现不具特异性,范围从隐匿的、非特异性的主诉到因低血容量性休克导致的循环衰竭。另一种难以诊断AI的情况是在危重症患者中。对于哪些患者应进行AI检测、使用哪些检测方法以及如何解读检测结果,目前尚无共识。在本循证综述中,我们旨在提供有关儿童和青少年新生儿期及危重症肾上腺功能评估结果和发现的信息。