CoChat
Sign Up
Cited by 131Adrenal Hormones and DisordersHormonal Regulation and HypertensionElectrolyte and hormonal disorders

The DOI matches its Crossref record; 13 of the 13 references it cites were found in a registry or an index.

Presentation of Primary Adrenal Insufficiency in Childhood

Hsieh, Susan, White, Perrin C.·2011·The Journal of Clinical Endocrinology & Metabolism
DOI 10.1210/jc.2011-0015
Open this paper in CoChat — free account

Abstract

Context: Primary adrenal insufficiency is usually diagnosed in infancy or adulthood, and cases presenting in childhood have not been systematically reviewed. Objective: Our objective was to determine etiologies, signs, and symptoms of primary adrenal insufficiency presenting in childhood. Design and Setting: We conducted a retrospective chart review at a tertiary-care pediatric hospital. Patients: Patients were children with corticoadrenal insufficiency, glucocorticoid deficiency, or mineralocorticoid deficiency. Results: Seventy-seven cases were identified in 1999–2010. Thirty-five had congenital adrenal hyperplasia (CAH) and were not reviewed further. Forty-two patients (20 diagnosed at our institution) had primary adrenal insufficiency. These had etiologies as follows: autoimmune (18), autoimmune polyendocrinopathy syndrome (an additional five), ACTH resistance (four), adrenoleukodystrophy (three), adrenal hypoplasia congenita (two), adrenal hemorrhage (two), IMAGe syndrome (one), and idiopathic (two). Of 20 patients diagnosed at our institution, two were being monitored when adrenal insufficiency developed and were not included in the analysis of presenting signs and symptoms: 13 of 18 patients were hypotensive; 12 of 18 had documented hyperpigmentation. Hyponatremia (<135 mEq/liter) occurred in 16 of 18. However, hyperkalemia (>5.0 mEq/liter) was noted in only nine. Hypoglycemia and ketosis were documented in four of 15 and four of six patients in whom it was sought, respectively. Fifteen patients underwent cosyntropin stimulation testing with median baseline and stimulated cortisol of 1.1 and 1.2 μg/dl, respectively. ACTH and renin were markedly elevated in all patients. Conclusions: Hyperkalemia is not a consistent presenting sign of primary adrenal insufficiency in childhood, and its absence cannot rule out this condition. A combination of chronic or subacute clinical symptoms, hypotension, and hyponatremia should raise suspicion of adrenal insufficiency.

Overview

Integrity signals

Registry

Crossref · 10.1210/jc.2011-0015

Cites

13 of 13 references verified0 citation errors · 0 not checkable

Statistics

Recomputing p-values needs the paper’s full text.

Verification

Claims the paper makes

This paper’s full text isn’t openly available, so its claims and self-check weren’t run. The registry and citation checks still apply.

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Citations

Cites

Flagged first, then by citations

Show all 12 references

Research works printed but not linked: 1

  1. White, 2007, Primary adrenal insufficiency, 2355

Cited by

Sorted by citations

Related

See all

Metadata

Authors
Hsieh, S., & White, P. C.
Affiliations
The University of Texas Southwestern Medical Center (US)
Corresponding author
White, Perrin C.
ORCID
White, Perrin C.
Venue
The Journal of Clinical Endocrinology & Metabolism
Publisher
The Endocrine Society
Published
2011-06-01
Volume
96
Issue
6
Pages
E925-E928
ISSN
  • 0021-972X (ISSN-L)
  • 1945-7197
DOI
10.1210/jc.2011-0015
OpenAlex
W2059681842
Cited by
131
References
12
Citations by year
2026: 2 · 2025: 11 · 2024: 6 · 2023: 3 · 2022: 9 · 2021: 7 · 2020: 13 · 2019: 12 · 2018: 10 · 2017: 10 · 2016: 9 · 2015: 16 · 2014: 7 · 2013: 7 · 2012: 8
FWCI
6.00
Type
journal article
Language
en
Open access
closed
Locations
  • The Journal of Clinical Endocrinology & Metabolism (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Adrenal Hormones and Disorders
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Hormonal Regulation and Hypertension
  • Health Sciences › Medicine › Nephrology › Electrolyte and hormonal disorders
Keywords
Addison's disease, childhood, pediatric adrenal insufficiency, autoimmune adrenal insufficiency, ACTH resistance, adrenoleukodystrophy, congenital adrenal hypoplasia, adrenal hemorrhage, IMAGe syndrome, hyponatremia, hypotension, hyperpigmentation, hyperkalemia, hypoglycemia, ketosis, ACTH stimulation test, ACTH, renin
MeSH terms
Addison Disease, Adolescent, Autoimmune Diseases, Child, Humans, Hypoglycemia, Hyponatremia, Hypotension, Retrospective Studies

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review