{"title":"Statin therapy and lipids-lowering supplements - safe and effective treatment of lipids disturbances in children.","authors":"Małgorzata Grabarczyk, Kinga Pomianowska, Tymoteusz Zaręba-Głód, Agnieszka Zachurzok, Ewa Małecka-Tendera, Paweł Matusik","doi":"10.5114/pedm.2022.116114","DOIUrl":"https://doi.org/10.5114/pedm.2022.116114","url":null,"abstract":"<p><strong>Introduction: </strong>There is a significant correlation between elevated LDL cholesterol (LDL-C) levels sustained from childhood and future vascular disease. The study aimed to evaluate the effectiveness and safety of the therapy chosen for children with lipid disorders.</p><p><strong>Material and methods: </strong>The study group consisted of 37 children with increased LDL-C (13 boys) aged 8.99 ±4.03 years. After 6 months of behavioral treatment, study group was divided into G1 (n = 24) which continued non-pharmacological treatment supported by dietary supplements and G2 (n = 13) in which statin (5-10 mg/day) was added to non-pharmacological treatment. Analysis included: BMI Z-score, total cholesterol (TCh), LDL-C, HDL cholesterol (HDL-C) and triglycerides (TG) measured at several time points.</p><p><strong>Results: </strong>The concentrations of TCh and LDL-C before treatment were significantly higher in G2 than in G1 (p < 0.001). Due to the treatment, these differences were no longer noticeable at the last visit. In G1 and G2 concentrations of TCh and LDL-C were reduced significantly, greater reduction after the treatment in TCh and LDL-C was observed in G2 than in G1. Moreover, in G1 we noticed reduction of TG after treatment (p < 0.05). The BMI Z-score did not change significantly through the treatment in both groups. G1 also showed a significant negative correlation between BMI Z-score and HDL-C before and after treatment (r = -0.57, p = 0.009; r = -0.52, p = 0.02). Same relationship was noticed also in G2 after treatment (r = 0.67, p = 0.05).</p><p><strong>Conclusions: </strong>In children with dyslipidemia, regardless of its background, statin therapy is the most effective in lowering LDL-C. However, therapy with lipids-lowering supplements seems to be safe and effective.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 2","pages":"108-113"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/ae/5e/PEDM-28-46998.PMC10214963.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9574798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Management of Prader-Labhart-Willi syndrome in children and in adults, with particular emphasis on the treatment with recombinant human growth hormone.","authors":"Marta Drabik, Andrzej Lewiński, Renata Stawerska","doi":"10.5114/pedm.2022.112861","DOIUrl":"https://doi.org/10.5114/pedm.2022.112861","url":null,"abstract":"<p><strong>Introduction: </strong>Prader-Willi syndrome (PWS) is a genetically determined disease that manifests itself in a number of abnormalities resulting, among others, from dysfunction of the hypothalamic-pituitary system. Only integrated, multidisciplinary care gives patients the chance to significantly improve the quality of life and achieve a life expectancy that does not differ from the general population.</p><p><strong>Aim: </strong>The aim of the study was to summarize the available literature on the management of patients suffering from PWS.</p><p><strong>Conclusions: </strong>More and more reports based on clinical trials conducted around the world indicate the undeniable benefits of rhGH therapy in patients with PWS in childhood and after the end of growth period. They consist in improving the body composition, improving the lipid profile, increasing bone mineral density and improving the mental state and patients' quality of life.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 1","pages":"64-74"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/16/02/PEDM-28-46241.PMC10226360.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9628408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pim Dekker, Martine de Vries, Henk-Jan Aanstoot, Joost Groen
{"title":"Which C-peptide assay do you use? Increasing need for describing C-peptide assay performance.","authors":"Pim Dekker, Martine de Vries, Henk-Jan Aanstoot, Joost Groen","doi":"10.5114/pedm.2022.113741","DOIUrl":"https://doi.org/10.5114/pedm.2022.113741","url":null,"abstract":"<p><p>Many C-peptide assays are commercially available for research and routine use. However, not all assays yield consistent results, especially in the low concentration ranges. We searched the literature describing C-peptide measurements to assess which assays are mainly used in the diabetes research field and if they are specified. Percentages of publications on C-peptide measurements in type 1 diabetes (T1D), type 2 diabetes (T2D) and other forms of diabetes were 32%, 54% and 14%, respectively. In only 54% of the publications the used assay was specified. Information on detection limit, measurement range and variation was provided in 12%, 2% and 11% of publications, respectively. In 22% of all publications no C-peptides concentrations were mentioned. This may be a problem especially for T1D research, where measuring very low levels of C-peptide is becoming increasingly important and concordance between assays is low.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 1","pages":"101-103"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cb/71/PEDM-28-46441.PMC10226358.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9628412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Beata Wikiera, Julita Nocoń-Bohusz, Anna Noczyńska
{"title":"Silver-Russell syndrome and Turner syndrome in a girl with short stature treated with growth hormone - case report.","authors":"Beata Wikiera, Julita Nocoń-Bohusz, Anna Noczyńska","doi":"10.5114/pedm.2022.121463","DOIUrl":"https://doi.org/10.5114/pedm.2022.121463","url":null,"abstract":"<p><strong>Introduction: </strong>Silver-Russell syndrome (SRS) is a rare condition, affects one in 100,000 births. Turner syndrome (TS) is a chromosomal disorder, with an incidence of one in 2,500 females. Patient with SRS and mosaic 45, X/46,X,del(X) karyotypes can have a wide range of phenotypic manifestations. The aim of this article is to present a case report of a patient with an extremely rare and not reported so far genetically confirmed diagnose of Silver-Russell syndrome and Turner syndrome.</p><p><strong>Case report: </strong>The patient is a 9-years old girl who had a karyotype of 45,X on prenatal amniocytes. After delivery she was small for gestational age and her phenotype was quite consistent with Russell-Silver syndrome: characteristic dimorphic facial skeleton with a triangular face with prominent forehead, thin nose, hypotonia and hemihyperthrophy. The girl was admitted to hospital due to short stature and deep body weight deficiency. Skin fibroblast and DNA analysis showed mosaic karyotype 45,X[14]/46,X,del(X)(p21.2) and hypomethylation of a gene H19 located on chromosome 11p15. At present the patient is treated with growth hormone in our clinic with good therapeutic results.</p><p><strong>Conclusions: </strong>The diagnosis of one genetic disorder does not rule out the possibility of a second genetic disease. Early diagnosis of coexistence of two different genetic syndromes, although very difficult, may help with quickly, appropriate therapy for patients and prevent them from developing serious complications.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 4","pages":"301-304"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/26/87/PEDM-28-48267.PMC10214936.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9947782","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Wolcott-Rallison syndrome: a case series of three patients.","authors":"Fozia Memon, Muzna Arif, Salman Kirmani, Khadija Humayun","doi":"10.5114/pedm.2022.118325","DOIUrl":"https://doi.org/10.5114/pedm.2022.118325","url":null,"abstract":"<p><strong>Introduction: </strong>Neonatal diabetes is a rare disease with incidence estimated at 1 in 300,000 to 1 in 400,000 live births. Walcott-Rallison syndrome has been identified as the most common cause of permanent neonatal diabetes in consanguineous families caused by mutations in eukaryotic translation initiation factor 2-α kinase 3 (EIF2AK3), characterized by permanent neonatal diabetes associated with liver dysfunction, multiple epiphyseal dysplasia, and developmental delay. We herein report 3 cases of genetically proven Wolcott-Rallison syndrome with variable phenotype presentation.</p><p><strong>Case series: </strong>All cases presented with high glucose levels and were treated with insulin. EIF2AK3 homozygous mutation was identified in all 3 on genetic analysis. Initial screening testing for associated comorbidities was normal, including X-ray examination, which did not show any signs of epiphyseal dysplasia in all cases. Case 2 and case 3 were both lost to follow-up and were later found to have expired at the ages of 18 months and 2 years, respectively, due to liver failure associated with intercurrent respiratory illness in hospitals in their native towns. Case one is now 2 years old on regular follow-up in paediatric Endocrine and neurology clinics and doing well so far.</p><p><strong>Conclusions: </strong>Morbidity, as well as mortality, is high among children with WRS neonatal diabetes. It is crucial to screen for gene mutation in patients with diabetes diagnosed before 6 months. Close therapeutic monitoring is recommended in WRS because of the risk of acute episodes of hypoglycaemia and ketoacidosis.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 3","pages":"238-240"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/64/a4/PEDM-28-47559.PMC10214929.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9573362","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Michał A Okruszko, Maciej Szabłowski, Katarzyna Pochodowicz, Katarzyna Taranta-Janusz, Artur Bossowski, Barbara Głowińska-Olszewska
{"title":"Atypical diabetes mellitus in children - when to suspect drug-induced diabetes. A case-based review of the literature.","authors":"Michał A Okruszko, Maciej Szabłowski, Katarzyna Pochodowicz, Katarzyna Taranta-Janusz, Artur Bossowski, Barbara Głowińska-Olszewska","doi":"10.5114/pedm.2022.118398","DOIUrl":"https://doi.org/10.5114/pedm.2022.118398","url":null,"abstract":"<p><strong>Introduction: </strong>Drug-induced diabetes mellitus (DIDM) could be defined as a heterogenic group of diabetes caused by pharmacotherapy. The DIDM is considered to be reversible after discontinuation of diabetogenic treatment, but there is a risk of persistence, which is related to the duration of treatment, prescribed medication, and body mass index.</p><p><strong>Case presentation: </strong>A 13-year-old boy treated for nephrotic syndrome with the use of tacrolimus and prednisone was diagnosed with diabetes during a check-up visit. On admission, he showed a cushingoid appearance and complained of dry mouth, which was not accompanied by polyuria or polydipsia. Blood tests showed elevated levels of glucose, and glycated A1c fraction of haemoglobin (HbA1c = 10.2%). Pancreatic islet autoantibodies were negative. The fasting and postprandial C-peptide levels were within the normal range. Diabetic ketoacidosis was excluded. Intensive insulin therapy was initially introduced; the daily dose of insulin per kilogram was low (TDD/kg = 0.31 U/kg). Those findings prompted us to consider diabetes mellitus type 2 or DIDM. Moreover, the TDD/kg and HbA1c additionally decreased after the steroid withdrawal. Because he was constantly on diabetogenic therapy and experienced periodical hyperglycaemia, DIDM could not be excluded. Therefore, our patient remained on insulin treatment.</p><p><strong>Conclusions: </strong>DIDM in children is challenging for all specialists. Diabetologists need to remember about this rare subtype of diabetes, and other specialist should perform screening on their patients who are at risk of DIDM. There is a great need for guidelines that would provide a standardized approach for diagnosing and treating DIDM in the paediatric population.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 4","pages":"294-300"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/e2/7f/PEDM-28-47569.PMC10214948.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9573363","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Magdalena Potempa-Jeziorowska, Paweł Jonczyk, Elżbieta Świętochowska, Marek Kucharzewski
{"title":"Analysis of ghrelin, leptin, and interleukin-6 salivary concentration among children aged 7-10 years and its relationship with nutritional status and some anthropometric data.","authors":"Magdalena Potempa-Jeziorowska, Paweł Jonczyk, Elżbieta Świętochowska, Marek Kucharzewski","doi":"10.5114/pedm.2022.119782","DOIUrl":"https://doi.org/10.5114/pedm.2022.119782","url":null,"abstract":"<p><strong>Introduction: </strong>Obesity is a complex condition with multifactorial aetiopathogenesis. Adipose tissue is reservoir of many adipokines which play a great role in proinflammatory response in obesity. Aim of the study: Comparative assessment of ghrelin, leptin, and interleukin-6 (IL-6) salivary concentration among children having proper and excess of body mass. Analysis of the interrelationship between the obtained concentrations of substances and selected anthropometric parameters and blood pressure values in the studied children.</p><p><strong>Material and methods: </strong>The study group comprised 102 children aged 7-10 years. The nutritional status of children was assessed by the use of the BMI index. The control group (n = 74) comprised children with proper body mass, and the study group (n = 28) contained children having overweight/obesity. Saliva samples were taken from all children at school. Subsequently, some anthropometric parameters and blood pressure values of the children were measured. The laboratory assessment of substances was made by ELISA method. Next, statistical analysis of all obtained results was performed using professional software.</p><p><strong>Results: </strong>Salivary ghrelin, leptin, and IL-6 concentrations were statistically significantly higher in the study group than in the control group (p = 0.001). The study revealed a positive correlation between salivary ghrelin concentration and BMI in the whole study population (p = 0.001), and between ghrelin concentration and body weight, waist circumference, hip circumference, and waist-to-hip ratio in all subjects. In the study group, the BMI value was positively correlated only with IL-6 saliva concentration (p = 0.005).</p><p><strong>Conclusions: </strong>The study revealed significant differences between saliva ghrelin, leptin, and IL-6 concentration between the control group and the study group. The above findings can be a good predictor with which to detect co-existing metabolic alternations in obese patients.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 4","pages":"263-273"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/cd/16/PEDM-28-47885.PMC10214976.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9573377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Magdalena Wszolek, Karolina Ziora-Jakutowicz, Piotr Gorczyca, Katarzyna Rojewska, Katarzyna Ziora
{"title":"Assessment of Long-Term Treatment Results in Women Suffering from Anorexia Nervosa in Adolescence.","authors":"Magdalena Wszolek, Karolina Ziora-Jakutowicz, Piotr Gorczyca, Katarzyna Rojewska, Katarzyna Ziora","doi":"10.5114/pedm.2021.109268","DOIUrl":"https://doi.org/10.5114/pedm.2021.109268","url":null,"abstract":"<p><strong>Introduction: </strong>Reports assessing long-term treatment outcomes for anorexia nervosa (AN) are divergent and refer to different populations. They lack long-term observations in AN patients in Poland.</p><p><strong>Aim of the study: </strong>Analysis of the recovery, relapse rate, and predictive factors in patients treated due to AN in adolescence.</p><p><strong>Material and methods: </strong>A total of 201 subjects were given a survey. Ninety-seven women were recruited: 56 reported to the clinic and 41 filled in the survey.</p><p><strong>Results: </strong>The average period from hospitalization to the survey was 7.76 ±4.39 years. Remission was found in 78.4%, 21.6% still pre-sented AN, and 84.2% required a one-off hospitalisation, 10.5% twice. The average BMI was: 20.08 ±3.24 kg/m 2 . The rate of attempted suicides was 6.2%. Predictive factors for poor outcome were as follows: older age of the patient when falling ill, lower SDS-BMI score at the onset of AN, transition from the restrictive type of AN into a binge-eating/purging type, and fail-ure to maintain contact with the mother.</p><p><strong>Conclusions: </strong>1. Most girls suffering from the restricting type of AN in adolescence are cured permanently. 2. The severity of symptoms in these girls does not eliminate the chance of recovery and achieving important life goals, com-pleting education, finding a life partner, and having children. 3. Girls with a smaller degree of cachexia at onset of AN, with no binge-eating/purging symptoms, maintaining regular con-tact with their mothers, have a better prognosis for recovery. 4. Six per cent of women treated in their youth for AN face the risk of attempted suicide, which points to the need to monitor their mental state for many years.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 1","pages":"4-15"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f2/cd/PEDM-28-45201.PMC10226369.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9574792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Elżbieta Moszczyńska, Marta Baszyńska-Wilk, Klaudia Zasada, Dorota Majak, Marta Szaniawska, Mieczysław Szalecki
{"title":"Pituitary stalk thickening in patients under 18 years of age - the most common causes and diagnostic procedures.","authors":"Elżbieta Moszczyńska, Marta Baszyńska-Wilk, Klaudia Zasada, Dorota Majak, Marta Szaniawska, Mieczysław Szalecki","doi":"10.5114/pedm.2022.115202","DOIUrl":"https://doi.org/10.5114/pedm.2022.115202","url":null,"abstract":"<p><strong>Introduction: </strong>Pituitary stalk thickening (PST) is a rare abnormality in children, and it may be challenging due to its diverse clinical picture.</p><p><strong>Aim of the study: </strong>The aim of the study is to summarize the data on the causes and diagnostic procedures of PST.</p><p><strong>Material and methods: </strong>Papers were searched in the PubMed database identifying published randomized clinical trials, reviews, systematic reviews, meta-analyses, and case reports.</p><p><strong>Results: </strong>The most common causes of a thickened pituitary stalk in children are germ cell tumours (GCTs), Langerhans cell histiocytosis (LCH), and lymphocytic infundibulo-neurohypophysitis (LINH). Neurosarcoidosis, pituitary tuberculosis, granulomatosis, or specific inflammations were only reported in the paediatric population as case studies. PST mainly affects teenagers and is often detected with brain magnetic resonance imaging (MRI) in patients with central diabetes insipidus (CDI). It is not possible to differentiate the causes of PST with the use of the MRI image alone. Although various biochemical and oncological markers and other imaging tests are used, the diagnosis of PST remains a significant diagnostic challenge for clinicians. The final diagnosis is made based on histopathological examination. The indications for a biopsy are not uniform. Most experts, including the authors of the 2021 British consensus, recommend biopsy in the case of PST with a stalk lesion diameter ≥ 6.5-7 mm.</p><p><strong>Conclusions: </strong>The differential diagnosis of PST is a challenge. The diagnostic and treatment strategy should be individually adapted. Patients should be diagnosed in large clinical centres with experience in this field.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 3","pages":"213-227"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/4d/a6/PEDM-28-46799.PMC10214961.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9566449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The function of adrenal glands in children and adolescents during and after oncological treatment.","authors":"Barbara Hull, Anna Wedrychowicz","doi":"10.5114/pedm.2022.118319","DOIUrl":"https://doi.org/10.5114/pedm.2022.118319","url":null,"abstract":"<p><p>The purpose of this work was to present the current state of knowledge on the effects of frequently used therapeutic forms, selected pharmacotherapy (including glucocorticosteroids, immune checkpoint inhibitors, mitotane, metyrapone, aminoglutetimide, etomidate, ketoconazole, fluconazole), but also radiation therapy on the functioning of the hypothalamic-pituitary-adrenal axis in children and adolescent during and after oncological treatment. The most common pediatric cancers, where complications of adrenal insufficiency occur, are presented. Moreover, current recommendations how to diagnose the function of the adrenal axis in oncological pediatric patients, as well during oncological treatment as after it, including patients treated with steroids and also patients in severe stages, are reported. The rules of the treatment of adrenal dysfunction in those patients are presented. This understanding is of key importance for oncologists and endocrinologists in the process of diagnosing, treating and developing patient health care, as well as during therapy as after it, offering safety and improving the quality of life.</p>","PeriodicalId":39165,"journal":{"name":"Pediatric Endocrinology, Diabetes and Metabolism","volume":"28 3","pages":"226-232"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/b8/df/PEDM-28-47553.PMC10214931.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9566468","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}