ReviewJournal of endocrinological investigation2025
Glucocorticoid treatment and adrenal suppression in children: current view and open issues.
Review in Journal of endocrinological investigation, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
15 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Steroid-induced adrenal insufficiency in children with nephrotic syndrome: a systematic review.Pediatric nephrology (Berlin, Germany) · 2026Pooled it
- Who and how to screen for Cushing's syndrome: the position statement of the Italian Society of Endocrinology.Journal of endocrinological investigation · 2026Guideline
- [Advances in growth impairment associated with pediatric respiratory diseases].Zhongguo dang dai er ke za zhi = Chinese journal of contemporary pediatrics · 2026Review
- Paroxysmal Speech Arrest With Resolving Splenial and Symmetric White Matter Lesions in a Child: A Case Report.Cureus · 2026Article
- Corticosteroids in asthma and COPD: an inflammopharmacological perspective on molecular and genetic determinants.Molecular biology reports · 2026Review
- Congenital Adrenal Hyperplasia in the Mediterranean: A Concise Overview.Pharmaceuticals (Basel, Switzerland) · 2026Review
- Article
- Postnatal Steroids in Preterm Infants: A Narrative Review Series-Part 3: Impacts on Growth, Neurodevelopment & Nutrition.Children (Basel, Switzerland) · 2026Review
- Systemic steroidophobia scale for pediatric rheumatology (SSS-PR): development and validation of a novel psychometric tool measuring clinician steroidophobia.Pediatric rheumatology online journal · 2026Article
- Neonatologists' practices in screening and managing corticosteroid-induced adrenal insufficiency in the NICU- a multicenter study.Journal of perinatology : official journal of the California Perinatal Association · 2026Review
- Adrenal Insufficiency in Children With Nephrotic Syndrome Treated With High Doses of Glucocorticoids.Acta paediatrica (Oslo, Norway : 1992) · 2026Article
- Mild Autonomous Cortisol Secretion in Congenital Adrenal Hyperplasia Managed With Mini Back Scope Adrenalectomy.JCEM case reports · 2026Article
- Long-term neuroendocrine consequences of early corticosteroid use in children.Annals of medicine and surgery (2012) · 2026Article
- Impact of glucocorticoid therapy on hypothalamic-pituitary-adrenal axis function in pediatric nephrotic syndrome: A narrative review.World journal of clinical pediatrics · 2025Review
- Safe Use of Corticosteroids in Non-Infectious Uveitis.Journal of inflammation research · 2025Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeGlucocorticoids (GCs) are commonly used for several acute and chronic pediatric diseases. However, chronic treatment may result in hypothalamic-pituitary-adrenal axis (HPA) dysfunction. Glucocorticoid-induced adrenal insufficiency (GI-AI) is indeed the most frequent cause of adrenal insufficiency (AI) in children, possibly resulting in a life-threatening event such as adrenal crisis (AC). It is generally underestimated, especially when using non-systemic glucocorticoid formulations. This review aims at summarizing current evidence on the effects of long-term GC treatment on the HPA axis, management of GC tapering and assessment of the HPA recovery.
methodsWe conducted a narrative review of the relevant literature focusing on pathogenic mechanisms, predictive factors, diagnosis and treatment of GI-AI.
resultsAll types of GCs, whatever the route of administration, may have suppressive effects on the HPA axis, especially when compounds with higher potency and long half-life are used. Moreover, chronic GC administration is the most common cause of Cushing syndrome in children. In order to overcome the risk of GI-AI, slow withdrawal of GCs is necessary. When approaching the replacement dose, it is recommended to switch to shorter half-life formulations such as hydrocortisone. Assessment of HPA axis recovery with basal and stimulated cortisol levels may help detecting children at risk of AC that may require hydrocortisone supplementation.
conclusionThe management of GI-AI in children is challenging and many areas of uncertainty remain. Improving the knowledge on long-term GC effects on HPA in children, the management of steroid discontinuation and emergency dosing may help preventing GI-AI symptoms and acute hospital admission for AC.
Indexed as
Identifiers
What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.