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The relation between adrenal function and the severity of bronchial hyperresponsiveness in children as measured by

J Barr1, M J Rapoport, T Tauber

  • 1Department of Pediatrics, Assaf Harofeh Medical Center, Zerifin, Israel.

Journal of Pediatric Endocrinology & Metabolism : JPEM
|April 2, 2002
PubMed

Insights

Children with severe asthma may experience relative adrenal insufficiency. Severely asthmatic children showed significantly lower 24-hour urinary free cortisol (UFC) excretion after ACTH stimulation compared to those with milder disease.

Area of Science:

  • Pediatric Pulmonology
  • Endocrinology
  • Asthma Research

Background:

  • Asthma severity varies significantly among individuals, with unclear reasons for extreme differences.
  • Understanding the underlying mechanisms of severe asthma attacks is crucial for effective management.

Purpose of the Study:

  • To investigate the hypothesis that children with more severe asthma exhibit relative adrenal insufficiency compared to those with milder disease.
  • To explore the relationship between asthma severity and adrenal function in pediatric patients.

Main Methods:

  • Studied 16 children (aged 8-16) with chronic asthma.
  • Assessed adrenal function via 24-hour urinary free cortisol (UFC) and plasma cortisol levels post-ACTH stimulation.
  • Evaluated bronchial hyperresponsiveness using the methacholine provocation test.

Main Results:

  • No significant difference in peak plasma cortisol response to ACTH between mild-moderate (Group A) and severe (Group B) bronchial hyperresponsiveness groups.
  • Severely asthmatic children (Group B) demonstrated significantly lower 24-hour UFC response to ACTH compared to Group A (p <0.01).

Conclusions:

  • Severely asthmatic children in the study exhibited reduced 24-hour UFC secretion, suggesting potential relative adrenal insufficiency.
  • Recommend providing a short course of inhaled steroids for home emergency use in high-risk asthma patients identified with this profile.
Abstract

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