Please use this identifier to cite or link to this item: http://docs.prosentient.com.au/prosentientjspui/handle/1/10483
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dc.contributor.authorChrisp, Georgina L-
dc.contributor.authorMaguire, Ann M-
dc.contributor.authorQuartararo, Maria-
dc.contributor.authorFalhammar, Henrik-
dc.contributor.authorKing, Bruce R-
dc.contributor.authorMunns, Craig F-
dc.contributor.authorTorpy, David J-
dc.contributor.authorHameed, Shihab-
dc.contributor.authorRushworth, R Louise-
dc.date2018-
dc.date.accessioned2018-12-20T03:31:40Z-
dc.date.accessioned2019-06-29T00:38:32Z-
dc.date.available2018-12-20T03:31:40Z-
dc.date.available2019-06-29T00:38:32Z-
dc.date.issued2018-11-
dc.identifier.citationClinical endocrinology 2018-11; 89(5): 577-585-
dc.identifier.urihttp://docs.prosentient.com.au/prosentientjspui/handle/1/10483-
dc.description.abstractEpisodes of acute adrenal insufficiency (AI)/adrenal crises (AC) are a serious consequence of congenital adrenal hyperplasia (CAH). This study aimed to assess morbidity from acute illness in CAH and identify factors associated with use of IV hydrocortisone, admission and diagnosis of an AC. An audit of acute illness presentations among children with CAH to paediatric hospitals in New South Wales, Australia, between 2000 and 2015. There were 321 acute presentations among 75 children with CAH. Two-thirds (66.7%, n = 214) of these resulted in admission and 49.2% (n = 158) of the patients received intravenous (IV) hydrocortisone. An AC was diagnosed in (9.0%). Prior to presentation, 64.2% (n = 206) had used oral stress dosing and 22.1% (n = 71) had been given intramuscular (IM) hydrocortisone. Vomiting was recorded in 61.1% (n = 196), 32.7% (n = 64) of whom had used IM hydrocortisone. Admission, AC diagnosis and use of stress dosing varied significantly between hospitals. IM use varied from 7.0% in one metropolitan hospital to 45.8% in the regional hospital. Children aged up to 12 months had the lowest levels of stress dosing and IV hydrocortisone administration. Higher numbers of prior hospital attendances for acute illness were associated with increased use of IM hydrocortisone. Prehospital and in-hospital management of children with CAH can vary between health services. Children under 12 months have lower levels of stress dosing prior to hospital than other age groups. Experience with acute episodes improves self-management of CAH in the context of acute illness in educated patient populations.-
dc.language.isoeng-
dc.subject21-hydroxylase deficiency-
dc.subjectadrenal crisis-
dc.subjectadrenal insufficiency-
dc.titleVariations in the management of acute illness in children with congenital adrenal hyperplasia: An audit of three paediatric hospitals.-
dc.typeJournal Article-
dc.identifier.doi10.1111/cen.13826-
dc.identifier.journaltitleClinical endocrinology-
dc.identifier.pubmedurihttps://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/30086199-
dc.identifier.pubmedidhttps://www.ezpdhcs.nt.gov.au/login?url=https://www.ncbi.nlm.nih.gov/pubmed/30086199-
dc.identifier.affiliationSchool of Medicine, Sydney, The University of Notre Dame Australia, Darlinghurst, New South Wales, Australia..-
dc.identifier.affiliationThe Children's Hospital, Westmead, New South Wales, Australia.. Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia..-
dc.identifier.affiliationSchool of Medicine, Sydney, The University of Notre Dame Australia, Darlinghurst, New South Wales, Australia..-
dc.identifier.affiliationDepartment of Endocrinology, Metabolism and Diabetes, Karolinska University Hospital, Stockholm, Sweden.. Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden.. Menzies School of Health Research and Royal Darwin Hospital, Tiwi, Northern Territory, Australia..-
dc.identifier.affiliationJohn Hunter Children's Hospital, Newcastle, New South Wales, Australia.. University of Newcastle, Newcastle, New South Wales, Australia..-
dc.identifier.affiliationThe Children's Hospital, Westmead, New South Wales, Australia.. Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia..-
dc.identifier.affiliationEndocrine and Metabolic Unit, Royal Adelaide Hospital and University of Adelaide, Adelaide, South Australia, Australia..-
dc.identifier.affiliationSydney Medical School, The University of Sydney, Sydney, New South Wales, Australia.. Sydney Children's Hospital, Randwick, New South Wales, Australia.. School of Women's and Children's Health, University of New South Wales, Kensington, New South Wales, Australia..-
dc.identifier.affiliationSchool of Medicine, Sydney, The University of Notre Dame Australia, Darlinghurst, New South Wales, Australia..-
dc.identifier.orcidhttp://orcid.org/0000-0003-0844-520X-
dc.identifier.orcidhttp://orcid.org/0000-0002-5622-6987-
dc.identifier.orcidhttp://orcid.org/0000-0002-6270-747X-
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