Frequency of stress dosing and adrenal crisis in paediatric and adult patients with congenital adrenal hyperplasia: a prospective study
Authors' conclusion
The AC incidence and frequency of SD in children and adults with CAH are high. In contrast to the paediatric cohort, the majority of SD in adults was not in accordance with the DGE recommendations, underlining the need for structured and repeated education of patients with particular focus on transition.
Study context
- Population
- Paediatric and adult patients with congenital adrenal hyperplasia (CAH) on life-long glucocorticoid replacement, and their parents
- Participants
- 187 vs 38
- Exposure
- Adults vs children with CAH
- Adultsn = 187
- Childrenn = 38
- Outcome
- Adrenal crisis (AC) incidence
Methodological detailsData on adrenal crisis (AC) and SD collected via patient diary; medical records reviewed and patient interviews in case of AC
- Data on AC and SD collected via patient diary; medical records reviewed and patient interviews in case of AC
Main finding
As reported in the abstract
AC incidence
Adults
8.4 per 100 patient years
Children
5.1 in 100 py
Observational data: associations, not effects.
Further findings
SD performed according to DGE recommendations
| Outcome | Adults | Children | P value |
|---|---|---|---|
| Stress dosing (SD) episodes | 195.4 SD episodes per 100 py | 169.7 per 100 py | |
| CAHKAQ disease knowledge scoreHigher in children | 16.0 (unspecified 4.0) | 18.0 (unspecified 1.0) | P = 0.001 |
Correlations in adults
- SD frequency vs AC incidence
- r = .235, P = .011
- SD frequency vs CAH knowledge assessment questionnaire (CAHKAQ) score
- r = .233, P = .014
- AC incidence vs CAHKAQ
- r = .193, P = .026
Original publication
Frequency of stress dosing and adrenal crisis in paediatric and adult patients with congenital adrenal hyperplasia: a prospective study. Eur J Endocrinol. Published 8 April 2024. doi:10.
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