Infants:
Hypoglycaemia Jaundice Neonatal hepatitis Poor feeding Weight faltering Hyperpigmentation Collapse, death |
Child:
Nausea, vomiting Weight loss, anorexia Hypotension, Postural hypotension Hypoglycaemia Worsening fatigue Hyperpigmentation Collapse, death History of recurrent infections |
Weight |
Total Dose in 24 Hours |
Infusion Rate (mix 50ml 0.9% sodium chloride with 50mg hydrocortisone to give 1mg/ml solution) |
≤10kg |
25mg |
1ml/hr |
10.1-20kg |
50mg |
2 ml/hr |
20.1-40kg |
100mg |
4ml/hr |
40.1-70kg |
150mg |
6ml/hr |
Over 70kg |
200mg |
8ml/hr |
Primary Adrenal Insufficiency |
Secondary Adrenal Insufficiency |
|
ACTH Levels |
Elevated |
Suppressed |
Glucocorticoid treatment |
Usually hydrocortisone |
Usually hydrocortisone (or prednisolone) |
Mineralocorticoid treatment |
Fludrocortisone |
Not required |
Primary Adrenal Insufficiency |
Secondary Adrenal Insufficiency |
|
Possible sodium and potassium abnormalities |
|
|
Other possible electrolyte abnormalities |
|
|
Treatment |
|
|
Document Version:
2.0 Lead Author: Dr Ed Hind, Consultant Paediatrician Co-Author: Dr David Lim, SpR Paediatric Endocrinology Professor Justin Davies, Consultant Paediatric Endocrinologist |
Approving Network:
Wessex Paediatric Endocrine Network Date of Approval: 11/2023 Review Date: 11/2026 |
PIER Contact |
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