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Abstract Details

Adrenal Insufficiency among Children treated with Hormonal Therapy for Infantile Spasms
Child Neurology and Developmental Neurology
Child Neurology and Developmental Neurology Posters (7:00 AM-5:00 PM)
083

To quantify the incidence of adrenal insufficiency (AI) among children with infantile spasms treated with high-dose corticosteroids and/or adrenocorticotropic hormone (ACTH).

Hormonal therapy is a standard treatment for children with infantile spasms. However, the high doses given and long treatment duration exposes patients to the potential risk of AI. There is presently limited data on occurrence of AI after hormonal therapy in this population. A case of an adrenal crisis at our center motivated us to look further into the risk of developing AI in such patients.

A retrospective chart review of patients treated for infantile spasms was performed between January 2009 to March 2020 in our hospital. Variables collected included sex, age, etiology, hormonal treatment, adrenal function testing and signs of AI. Analysis included descriptive statistics such as incidence.

29 patients met the inclusion criteria and received hormonal treatment (19 received corticosteroids [prednisone/prednisolone], 6 received ACTH and 4 received both). Post-hormonal treatment testing of adrenal function was obtained in 26/29 (90%) patients. AI occurred in 20/26 (77%) of children who had testing. One patient presented to the emergency room with an acute adrenal crisis, the day following the weaning off of hormonal treatment.
Our study suggests that adrenal suppression is frequent after standard hormonal therapy regimen for infantile spasms. This can lead to serious complications, such as adrenal crisis, if not supplemented. A routine laboratory assessment of adrenal function should be considered after hormonal therapy for all patients. We suggest hydrocortisone supplementation therapy should be given at the end of hormonal therapy and until testing results for adrenal function are obtained.
Authors/Disclosures
Gabrielle Doré-Brabant
PRESENTER 		Gabrielle Doré-Brabant has nothing to disclose.
No disclosure on file
No disclosure on file
No disclosure on file
Bradley Osterman, MD (Montreal Children's Hospital) Dr. Osterman has received personal compensation in the range of $5,000-$9,999 for serving on a Speakers Bureau for Shire Pharma (Takeda). Dr. Osterman has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for l'Institut national d'excellence en santé et en services sociaux .
Nicolas Chrestian, MD Dr. Chrestian has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Novartis. Dr. Chrestian has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Roche. Dr. Chrestian has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Peer choice.