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Adrenal Insufficiency in Children With Juvenile Idiopathic Arthritis (Jia) Treated With Prednisolone Publisher



Sadeghi P1 ; Aghighi Y1 ; Ziaee V2, 3 ; Moayeri H4
Authors
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Authors Affiliations
  1. 1. Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Pediatric Rheumatology Research Group, Rheumatology Research Center, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Children's Medical Center, Pediatrics Center of Excellence, Tehran, Iran
  4. 4. Department of Endocrinology, Imam Khomeini Hospital, Tehran University of Medical Sciences, Tehran, Iran

Source: Journal of Comprehensive Pediatrics Published:2019


Abstract

Background: Corticosteroids are options for the treatment of juvenile idiopathic arthritis (JIA) although with adverse effects. Adrenal insufficiency (AI) may happen after therapeutic glucocorticoid administration. Objectives: We designed a study to assess the adrenal insufficiency in children with JIA undergoing treatment with low-dose gluco-corticosteroids for at least six months. Methods: This cross-sectional study was conducted at Imam Khomeini hospital and Children Medical Center hospital on 36 JIA patients after at least three months of cessation of low-dose, long-term corticosteroid therapy. Data regarding age, sex, age at diagnosis, the subtype of disease, and duration of treatment with corticosteroid were recorded. Fasting cortisol and cortisol after ACTH administration were measured. The AI diagnosis was made if the first level of cortisol was less than 3 µg/dL and the second level was less than 20 µg/dL. Results: The sample included 25 women (69.4%) with an overall mean age of 8.2 ± 3.4 years. The mean age at the time of diagnosis was 6.3 ± 3.2 years. The type of disease was oligoarticular in 32 (88.9%) cases and systemic in four (11.1%). Four cases had AI, all of whom were female with oligo-articular arthritis. In all the four cases, the adrenal function became normal three months after prednisolone cessation. The age at the time of study and the age at the time of disease diagnosis were significantly different between cases with and without AI. Conclusions: Adrenal insufficiency is not prevalent in children with JIA treated with low-dose glucocorticoids for a short time. Copyright © 2019, Journal of Comprehensive Pediatrics.