The Journal of Pediatrics
Volume 156, Issue 2 , Pages 296-301 , February 2010

Adrenal Cortisol Secretion Capacity in Children and Adolescents with New-Onset, Mild Crohn's Disease

  • Amnon Zung, MD

      Affiliations

    • Pediatric Endocrinology Unit, Kaplan Medical Center, Affiliated with the Hebrew University of Jerusalem, Israel
    • Corresponding Author InformationReprint requests: Amnon Zung, MD, Pediatric Endocrinology Unit, Kaplan Medical Center, Rehovot 76100, Israel.
    • ,
  • Michal Kori, MD

      Affiliations

    • Pediatric Gastroenterology Units of Kaplan Medical Center, Israel
    • ,
  • Gabriel Dinary, MD

      Affiliations

    • Schneider Children Hospital, Israel
    • ,
  • Efrat Broide, MD

      Affiliations

    • Asaf Harofe Hospital, Israel
    • ,
  • Baruch Yerushalmi, MD

      Affiliations

    • Soroka Medical Center, Israel
    • ,
  • Arie Levine, MD

      Affiliations

    • Wolfson Medical Center, Tel Aviv University, Israel

Received 4 February 2009 ,Revised 4 August 2009 ,Accepted 26 August 2009.

References 

  1. McGuckin MA, Eri R, Simms LA, Florin TH, Radford-Smith G. Intestinal barrier dysfunction in inflammatory bowel diseases. Inflamm Bowel Dis. 2009;15:100–113
  2. Packev CD, Sartor RB. Interplay of commensal and pathogenic bacteria, genetic mutations, and immunoregulatory defects in the pathogenesis of inflammatory bowel diseases. J Intern Med. 2008;263:596–606
  3. Stasi C, Orlandelli E. Role of the brain-gut axis in the pathophysiology of Crohn's disease. Dig Dis. 2008;26:156–166
  4. Auphan N, DiDonato JA, Rosette C, Helmberg A, Karin M. Immunosuppression by glucocorticoids: inhibition of NF-kappa B activity through induction of I kappa B synthesis. Sceince. 1995;270:286–290
  5. Suzuki T, Suzuki N, Daynes RA, Engleman EG. Dehydroepiandrosterone enhances IL2 production and cytotoxic effector function of human T cells. Clin Immunol Immunopathol. 1991;61:201–211
  6. Padgett DA, Loria RM. In vitro potentiation of lymphocyte activation by dehydroepiandrosterone, androstenediol, and androstenetriol. J Immunol. 1994;153:1544–1552
  7. Straub RH, Vogl D, Gross V, Lang B, Scholmerich J, Andus T. Association of humoral markers of inflammation and dehydroepiandrosterone sulfate or cortisol serum levels in patients with chronic inflammatory bowel disease. Am J Gastroenterol. 1998;11:2197–2202
  8. de la Torre B, Hedman M, Befrits R. Blood and tissue dehydroepiandrosterone sulphate levels and their relationship to chronic inflammatory bowel disease. Clin Exp Rheumatol. 1998;16:579–582
  9. Szathmari M, Vasarhelyi B, Treszl A, Tulassay T, Tulassay Z. Association of dehydroepiandrosterone sulfate and testosterone deficiency aith bone turnover in men with inflammatory bowel disease. In J Colorectal Dis. 2002;17:63–66
  10. Lahita RG, Bradlow HL, Ginzler E, Pang S, New M. Low plasma androgens in women with systemic lupus erythematosus. Arthritis Rheum. 1987;30:241–248
  11. Straub RH, Zeuner M, Antoniou E, Scholmerich J, Lang B. Dehydroepiandrosterone sulfate is positively correlated with soluble interleukin 2 receptor and soluble intercellular adhesion molecule in systemic lupus erythematosus. J Rheumatol. 1996;23:856–861
  12. La Montagna G, Baruffo A, Buono G, Valentini G. Dehydroepiandrosterone sulphate serum levels in systemic sclerosis. Clin Exp Rheumatol. 2001;19:21–26
  13. de la Torre B, Hedman M, Nilsson E, Olesen O, Thorner A. Relationship between blood and joint tissue DHEAS levels in rheumatoid arthritis and osteoarthritis. Clin Exp Rheumatol. 1993;11:597–601
  14. Cutolo M, Foppiani L, Minuto F. Hypothalamic-pituitary-adrenal axis impairment in the pathogenesis of rheumatoid arthritis and polymyalgia rheumatica. J Endocrinol Invest. 2002;25:19–23
  15. Foppiani L, Cutolo M, Sessarego P, Sulli A, Prete C, Seriolo B, et al. Desmopresin and low-dose ACTH test in rheumatoid arthritis. Eur J Endocrinol. 1998;138:294–301
  16. Desrame J, Sabate JM, Agher R, Bremont C, Gaudric M, Couturier D, et al. Assessment of hypothalamic-pituitary-adrenal axis function after corticosteroid therapy in inflammatory bowel disease. Am J Gastroenterol. 2002;97:1785–1791
  17. Neeck G, Federlin K, Graef V, Rusch D, Schmidt KL. Adrenal secretion of cortisol in patients with rheumatoid arthritis. J Rheumatol. 1989;17:24–29
  18. Chikanza IC, Petrou P, Kingsley G, Chrousos G, Panayi G. Defective hypothalamic response to immune and inflammatory stimuli in patients with rheumatoid arthritis. Arthritis Rheum. 1992;35:1291–1298
  19. Gutierrez MA, Garcia ME, Rodriguez JA, Rivero S, Jacobelli S. Hypothalamic-pituitary-adrenal axis function and prolactin secretion in systemic lupus erythematosus. Lupus. 1998;6:404–408
  20. Rovensky J, Blaziockova S, Rauova L, Jezova D, Koska J, Lukac J, et al. The hypothalamic-pituitary response in SLE. Regulation of prolactin, growth hormone, and cortisol release. Lupus. 1998;7:409–413
  21. Johnson EO, Vlachoyiannopoulos PG, Skopouli FN, Tzioufas AG, Moutsopoulos HM. Hypofunction of the stress axis in Sjogren's syndrome. J Rheumatol. 1998;25:1508–1514
  22. Levine A, Kori M, Dinari G, Broide E, Shaoul R, Yerushalmi B, et al. Comparison of two dosing methods for induction of response and remission with oral budesonide in active pediatric Crohn's disease: a randomized placebo controlled trial. Inflamm Bowel Dis. 2009;15:1055–1061
  23. Levine A, Weizman Z, Shamir R, Shaoul R, Pacht A, Dinary G, et al. A comparison of budesonide and prednisone for the treatment of active pediatric Crohn's disease. J Pediatr Gastroenterol Nutr. 2003;36:248–252
  24. IBD working group of the European society for pediatric gastroenterology, hepatology and nutrition. Inflammatory bowel disease in children and adolescents: recommendation for diagnosis – the Porto criteria. J Pediatr Gastroenterol Nutr. 2005;41:1–7
  25. Hymas JS, Ferry G, Mandel FS, Gryboski JD, Kibort PM, Kirschner BS, et al. Development and validation of a pediatric Crohn's disease activity index. J Pediatr Gastroenterol Nutr. 1991;12:439–447
  26. Axelrod L. Perioperative management of patients treated with glucocorticoids. Endocrinol Metab Clin N Am. 2003;32:367–383
  27. White PC, New MI, Dupont B. Congenital adrenal hyperplasia: part 1. N Eng J Med. 1987;316:1519–1524
  28. Ginsberg LJ. A practical approach to tolerance testing in children. In:  Lifshitz F editors. Pediatric Endocrinology. New York and Basel: Marcel Dekker Inc; 1990;p. 958–959
  29. Orth DN, Kovacs W. The adrenal cortex. In: Williams textbook of endocrinology. Philadelphia: W.B. Saunders Company; 1998;p. 618
  30. Mudter J, Neurath MF. IL-6 signaling in inflammatory bowel disease: pathophysiological role and clinical relevance. Inflamm Bowel Dis. 2007;13:1016–1023
  31. Zarkovic M, Ignjatovic S, Dajak M, Ciric J, Beleslin B, Savic S, et al. Cortisol response to ACTH stimulation correlates with blood interleukin 6 concentration in healthy humans. Eur J Endocrinol. 2008;159:649–652
  32. Priftis KN, Papadimitriou A, Nicolaidou P, Chrousos GP. The hypothalamic-pituitary-adrenal axis in asthmatic children. Trends Endocrinol Metab. 2008;19:32–38
  33. Vihinen MK, Raivio T, Verkasalo M, Janne OA, Kolho KL. Circulating glucocorticoid bioactivity during peroral glucocorticoid treatment in children and adolescent with inflammatory bowel disease. J Clin Gastroenterol. 2008;42:1017–1024
  34. Levine A, Broide E, Stein M, Bujanover Y, Weizman Z, Pacht A, et al. Evaluation of oral budesonide for treatment of mild and moderate exacerbation of Crohn's disease in children. J Pediatr. 2002;140:75–80
  35. Cooper MS, Stewart PM. Corticosteroid insufficiency in acutely ill patients. N Eng J Med. 2003;348:727–734
  36. Salem M, Tainsh RE, Bromberg J, Loriaux DL, Chernow B. Perioperative glucocorticoid coverage. Ann Surg. 1994;219:416–425
  37. Parker LN, Levin ER, Lifrak ET. Evidence for adrenocortical adaptation to severe illness. J Clin Endocrinol Metab. 1985;60:947–952
  38. Beishuizen A, Thijs LG, Vermes I. Decreased levels of dehydroepiandrosterone sulphate in severe critical illness: a sign of exhausted adrenal reserve?. Crit Care. 2002;6:434–438

 The authors declare no conflicts of interest.

PII: S0022-3476(09)00871-3

doi: 10.1016/j.jpeds.2009.08.046

The Journal of Pediatrics
Volume 156, Issue 2 , Pages 296-301 , February 2010

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