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Related Concept Videos

Adrenal Gland Disorders01:27

Adrenal Gland Disorders

Adrenal gland disorders manifest when the production of adrenal hormones deviates from the norm, resulting in either excessive or insufficient concentrations.
Adrenal insufficiency, characterized by insufficient cortisol and aldosterone production, leads to conditions like Addison's disease. This disorder, affecting the adrenal cortex, exhibits symptoms such as skin bronzing, dehydration, low blood pressure, fatigue, and weight loss. Congenital adrenal hyperplasia, a genetic ailment causing...
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...
Pharmacokinetics in Pediatric Patients: Drug Excretion01:26

Pharmacokinetics in Pediatric Patients: Drug Excretion

In pediatric medicine, understanding the renal function and drug elimination nuances is crucial for administering safe and effective treatments. Newborns, in particular, display markedly slower renal functions than adults, profoundly affecting how drugs are cleared from their bodies. This slower drug clearance requires clinicians to extend the dosing intervals for many medications to prevent drug accumulation and toxicity while ensuring therapeutic efficacy.One key area where these adjustments...
Pharmacokinetics in Pediatric Patients: Drug Metabolism01:24

Pharmacokinetics in Pediatric Patients: Drug Metabolism

In pediatric care, understanding the nuances of hepatic drug metabolism is crucial, as it significantly differs from that of adults. This divergence is primarily due to the developmental stage of drug-metabolizing enzymes, which affects how medications are processed in the body. In neonates, for instance, the activity of Phase I enzymes—critical for the initial breakdown of drugs—is markedly reduced, functioning at just 20–40% of the levels seen in adults. This reduction poses a challenge in...
Kidney Transplant III: Nursing Management01:16

Kidney Transplant III: Nursing Management

Postoperative Nursing Management for Kidney Transplant PatientsPostoperative nursing management care includes monitoring the surgical site, encouraging early movement, and promoting lung health through breathing exercises. Nurses also administer prescribed medications like H2-blockers, such as famotidine, or proton pump inhibitors, like omeprazole, to help prevent gastrointestinal ulcers and bleeding. Fungal infections in the mouth and bladder can result from immunosuppressive and antibiotic...
Serum Studies: Renal Function Tests01:24

Serum Studies: Renal Function Tests

Renal function tests are crucial for assessing kidney health, monitoring disease progression, and evaluating the kidneys' efficiency in waste elimination, fluid balance, and electrolyte regulation. These tests offer critical insights into kidney function, even though routine measurements may appear normal until there is a significant decline in the glomerular filtration rate or GFR. Typically, signs of kidney impairment only become evident when the GFR falls to about 50% of its normal level.

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Related Experiment Video

Updated: Jun 21, 2026

A Novel Method: Super-selective Adrenal Venous Sampling
06:08

A Novel Method: Super-selective Adrenal Venous Sampling

Published on: September 15, 2017

Adrenal function testing in pediatric cancer survivors.

Briana C Patterson1, Lauren Truxillo, Karen Wasilewski-Masker

  • 1Division of Endocrinology, Department of Pediatrics, Emory University, Atlanta, Georgia, USA. bcpatte@emory.edu

Pediatric Blood & Cancer
|July 29, 2009
PubMed
Summary

Central adrenal insufficiency is common in pediatric cancer survivors post-cranial radiation. The low-dose corticotropin test (LDCT) is recommended for screening patients with higher radiation doses or other endocrine issues.

Related Experiment Videos

Last Updated: Jun 21, 2026

A Novel Method: Super-selective Adrenal Venous Sampling
06:08

A Novel Method: Super-selective Adrenal Venous Sampling

Published on: September 15, 2017

Area of Science:

  • Pediatric Oncology
  • Endocrinology
  • Radiation Oncology

Background:

  • Cranial radiation therapy for cancer can lead to central adrenal insufficiency.
  • Screening for this condition is recommended, but optimal strategies remain unclear.

Purpose of the Study:

  • To evaluate the effectiveness of different screening methods for central adrenal insufficiency in pediatric cancer survivors.
  • To determine the prevalence of adrenal insufficiency based on radiotherapy dose and endocrine comorbidities.

Main Methods:

  • Retrospective review of pediatric cancer survivors undergoing hypothalamic/pituitary/adrenal axis testing.
  • Comparison of 8 a.m. serum cortisol levels with low-dose corticotropin test (LDCT) and standard-dose corticotropin test (SDCT) results.
  • Analysis of adrenal function based on radiotherapy dose and presence of endocrine comorbidities.

Main Results:

  • Central adrenal insufficiency was diagnosed in a significant portion of survivors, increasing with radiotherapy dose (up to 83% with >40 Gy).
  • Low-dose corticotropin test (LDCT) identified more cases than baseline 8 a.m. cortisol levels.
  • Agreement between baseline cortisol and LDCT was fair, while agreement with random cortisol was poor.

Conclusions:

  • Central adrenal insufficiency is prevalent in pediatric cancer survivors, even with radiation doses below 40 Gy.
  • Recommend LDCT over 8 a.m. serum cortisol for screening patients receiving >30 Gy radiotherapy or with other central endocrinopathies.