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A case of adrenal insufficiency during multisystem inflammatory syndrome in children

Fatih Kilci1, Ayşe Filiz Yetimakman2, Jeremy Huw Jones3

  • 1Department of Pediatrics, Division of Pediatric Endocrinology, Kocaeli University School of Medicine, Kocaeli, Turkey.

Clinical Pediatric Endocrinology : Case Reports and Clinical Investigations : Official Journal of the Japanese Society for Pediatric Endocrinology
|August 5, 2022
PubMed

Insights

Multisystem inflammatory syndrome in children (MIS-C) can impact the endocrine system. COVID-19 may cause adrenal insufficiency, potentially impairing cortisol dynamics and increasing patient morbidity.

Area of Science:

  • Endocrinology
  • Pediatrics
  • Infectious Diseases

Background:

  • Multisystem inflammatory syndrome in children (MIS-C) is a serious condition linked to COVID-19.
  • Limited data exists on COVID-19's impact on the pediatric endocrine system.
  • Understanding these effects is crucial for managing post-COVID complications.

Observation:

  • An 11-year-old boy presented with MIS-C symptoms following a COVID-19 infection.
  • The patient developed severe hyponatremia, hypotension, and tachycardia.
  • Initial treatment involved glucocorticoids, followed by hydrocortisone for adrenal insufficiency.

Findings:

  • The patient exhibited adrenal insufficiency after COVID-19 infection.
  • Cortisol dynamics were significantly affected, with no recovery of adrenal axis function after four months.
  • This suggests a potential for impaired adrenocortical response in pediatric COVID-19 cases.

Implications:

  • COVID-19 may lead to prolonged adrenal insufficiency in children.
  • Impaired cortisol dynamics could increase morbidity and mortality in affected children.
  • Further research is needed to explore the long-term endocrine consequences of COVID-19 in pediatric populations.

Keywords:
adrenal insufficiencycoronavirus disease 2019 (COVID-19)cortisol

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