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Master Thesis

Étude rétrospective sur l'insuffisance surrénale à l'arrêt d'une corticothérapie prolongée chez les enfants et adolescents atteints de maladie inflammatoire chronique intestinale suivis au CHU de Caen

Abstract : Introduction: Adrenal insufficiency is one of the complications of long-term corticosteroid therapy during flare-ups of inflammatory bowel disease (IBD). The main risk is acute decompensation, which can be lethal. However, the recommendations of pediatric gastroenterology don’t recommend Hydrocortisone or biological tests for systematic screening. Methods: We conducted a retrospective study from 2006 to 2020 to evaluate the clinical practices about the screening of adrenal insufficiency after corticosteroid therapy in IBD children. Results: Among 119 IBD patients, 58 received 1 to 3 courses of corticosteroids, with a total 91 courses. Among the 58 patients, there were 30 boys, age at diagnosis was 11.9±3.18 years and 55% had Crohn’s disease. Only 19 screening results were found following the 91 courses, 12 of which showed adrenal insufficiency. The estimated adrenal insufficiency rate was 63%. Hydrocortisone relay was prescribed in 13 of 91 corticosteroid courses. Conclusion: Our study found a wide variety of clinical practices about the decrease of corticosteroid treatment and the screening of adrenal insufficiency. We therefore used the data from the literature and the recommendations of the French Society of Endocrinology to establish a screening protocol in order to standardize clinical practices.
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https://dumas.ccsd.cnrs.fr/dumas-03166180
Contributor : Ufr Santé Unicaen <>
Submitted on : Thursday, March 11, 2021 - 10:30:24 AM
Last modification on : Tuesday, April 13, 2021 - 3:29:17 AM

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  • HAL Id : dumas-03166180, version 1

Citation

Camille Grandjean. Étude rétrospective sur l'insuffisance surrénale à l'arrêt d'une corticothérapie prolongée chez les enfants et adolescents atteints de maladie inflammatoire chronique intestinale suivis au CHU de Caen. Médecine humaine et pathologie. 2020. ⟨dumas-03166180⟩

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