Affiliation:
1. Cincinnati Neurological Associates, Inc and the departments of neurology and pediatrics, University of Cincinnati, Cincinnati, OH
Abstract
Suppression of an adrenocorticotropic hormone (ACTH) response to insulin hypoglycemia has been reported in ACTH-treated adults. There are no guidelines for withdrawal of ACTH treatment in children. After observing suppressed morning cortisol in several children, insulin tolerance tests were performed in five children within 48 hours after tapered withdrawal of ACTH treatment for myoclonic seizures. ACTH response, as determined by cortisol and β-endorphin radioimmunoassay, was adequate in four of the children. One child showed low basal levels and minimal elevation during hypoglycemia for both β-endorphin (0 to 3 pg/ml) and cortisol (3.6 to 4.4 μg/dL) on initial testing, but normal responses six weeks later. Measurement of β-endorphin response supported a central basis for suppression in the child, who had had an adrenal hemorrhage during gram-negative sepsis while on ACTH. ACTH release is transiently suppressed in some children after exogenous ACTH treatment. Tapered withdrawal and stress coverage is recommended. (J Child Neurol 1986:1;34-37).
Subject
Neurology (clinical),Pediatrics, Perinatology and Child Health
Cited by
14 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献