Adrenal function after prednisolone treatment in childhood nephrotic syndrome

• Published in: Journal of the Medical Association of Thailand Vol. 77; no. 3; p. 126
• Main Authors: Sumboonnanonda, A, Vongjirad, A, Suntornpoch, V, Petrarat, S
• Format: Journal Article
• Language: English
• Published: Thailand 01-03-1994
• Subjects: Adolescent; Adrenal Cortex Function Tests; Adrenal Glands - drug effects; Adrenal Glands - physiopathology; Child; Child, Preschool; Female; Humans; Male; Nephrotic Syndrome - drug therapy; Prednisolone - adverse effects; Prospective Studies
• ISSN: 0125-2208

Nephrotic syndrome in children is a very common disease in Thailand. Most of the patients respond well to oral prednisolone treatment but side effects of the drug especially adrenal insufficiency remains a threat to all. We studied the adrenal function by studying the response to ACTH stimulation test in 14 Thai children, nine girls and five boys, with idiopathic nephrotic syndrome: immediately, 3, 6 and 9 months after discontinuation of oral prednisolone treatment. Average age on entry to the study was 104.4 months (25-183 months). Prednisolone was given every day for 29 days (6-64 days) then every other day for 542 days (178-1,562 days). Side effects of steroid treatment were gross obesity BMI > 30 (one patient), moderate hypertension (one patient), and marked cushingoid features (two patients). ACTH stimulation tests were normal in 64 per cent of patients within 7 days, 64 per cent at 3 months, 73 per cent at 6 months, and 90 per cent at 9 months after discontinuation of oral prednisolone. We suggest that adrenal insufficiency has to be considered in all children on prolonged prednisolone unit at least 9 months of treatment-free period.