{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T04:53:06Z","timestamp":1781499186788,"version":"3.54.1"},"reference-count":7,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T00:00:00Z","timestamp":1781481600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100010090","name":"Women","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100010090","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100022895","name":"Health Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100022895","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100021472","name":"Department of Pediatrics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100021472","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Inhaled corticosteroids (ICS) are the foundation of treatment for pediatric asthma, and ICS are significantly safer than repeated courses of systemic steroids. However, systemic effects from ICS include adrenal suppression (AS), which is under recognized and can be life-threatening. Signs and symptoms of AS are often subtle and can be difficult to recognize. The Canadian Pediatric Society and Adrenal Suppression Working Group recommend screening for AS in: asymptomatic children receiving high dose ICS therapy for \u22653 months, any dose ICS in conjunction with a CYP3A4 inhibitor, and any children with AS symptoms, regardless of ICS dose. Screening should be done with a morning serum cortisol, and consultation with Pediatric Endocrinology is warranted if morning cortisol is low or there is high clinical suspicion. Factors such as age-specific dosing, ICS administration technique and adherence, comorbidities, and triggers should be considered when managing asthma to decrease risk of AS.<\/jats:p>","DOI":"10.1093\/pch\/pxag048","type":"journal-article","created":{"date-parts":[[2026,5,6]],"date-time":"2026-05-06T11:40:08Z","timestamp":1778067608000},"source":"Crossref","is-referenced-by-count":0,"title":["Adrenal suppression secondary to inhaled corticosteroids"],"prefix":"10.1093","author":[{"given":"Corin","family":"MacPhail","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta , Edmonton, Alberta ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Rosolowsky","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta , Edmonton, Alberta ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Connie","family":"Yang","sequence":"additional","affiliation":[{"name":"Division of Pediatric Respirology, Department of Pediatrics, Faculty of Medicine & Dentistry, University of Toronto , Toronto, Ontario ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teresa","family":"Pinto","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Dalhousie University , Halifax, Nova Scotia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carly","family":"Baxter","sequence":"additional","affiliation":[{"name":"Division of Pediatric Endocrinology, Department of Pediatrics, Faculty of Medicine, Dalhousie University , Halifax, Nova Scotia ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6553-3826","authenticated-orcid":false,"given":"Anne","family":"Hicks","sequence":"additional","affiliation":[{"name":"Division of Pediatric Respirology, Department of Pediatrics, Faculty of Medicine & Dentistry, University of Alberta , Edmonton, Alberta ,","place":["Canada"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,15]]},"reference":[{"issue":"4","key":"2026061500071747100_pxag048-B1","doi-asserted-by":"publisher","first-page":"242","DOI":"10.1093\/pch\/pxab015","article-title":"Adrenal suppression from exogenous glucocorticoids: Recognizing risk factors and preventing morbidity","volume":"26","author":"Ahmet","year":"2021","journal-title":"Paediatr Child Health"},{"issue":"1","key":"2026061500071747100_pxag048-B2","doi-asserted-by":"publisher","first-page":"43","DOI":"10.2174\/1573396315666191026100643","article-title":"Headliner in physiology and management of childhood asthma: Hypothalamic-Pituitary-Adrenal axis","volume":"16","author":"Akcan","year":"2020","journal-title":"Curr Pediatr Rev"},{"issue":"4","key":"2026061500071747100_pxag048-B3","doi-asserted-by":"publisher","first-page":"338","DOI":"10.1136\/archdischild-2016-311223","article-title":"Symptomatic adrenal suppression among children in Canada","volume":"102","author":"Goldbloom","year":"2017","journal-title":"Arch Dis Child"},{"issue":"1","key":"2026061500071747100_pxag048-B4","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/s13223-015-0075-z","article-title":"CSACI position statement: Systemic effect of inhaled corticosteroids on adrenal suppression in the management of pediatric asthma","volume":"11","author":"Issa-El-Khoury","year":"2015","journal-title":"Allergy Asthma Clin Immunol"},{"issue":"1","key":"2026061500071747100_pxag048-B5","doi-asserted-by":"publisher","first-page":"13","DOI":"10.1186\/1710-1492-7-13","article-title":"Adrenal suppression: A practical guide to the screening and management of this under-recognized complication of inhaled corticosteroid therapy","volume":"7","author":"Ahmet","year":"2011","journal-title":"Allergy Asthma Clin Immunol"},{"issue":"6","key":"2026061500071747100_pxag048-B6","doi-asserted-by":"publisher","first-page":"348","DOI":"10.1080\/24745332.2021.1945887","article-title":"Canadian Thoracic Society 2021 Guideline update: Diagnosis and management of asthma in preschoolers, children and adults","volume":"5","author":"Yang","year":"2021","journal-title":"Can J Respir Crit Care Sleep Med"},{"issue":"2","key":"2026061500071747100_pxag048-B7","doi-asserted-by":"publisher","first-page":"122","DOI":"10.1093\/pch\/pxae006","article-title":"The management of very mild and mild asthma in preschoolers, children, and adolescents","volume":"29","author":"Yang","year":"2024","journal-title":"Paediatr Child Health"}],"container-title":["Paediatrics &amp; Child Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/pch\/advance-article-pdf\/doi\/10.1093\/pch\/pxag048\/68524231\/pxag048.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/pch\/advance-article-pdf\/doi\/10.1093\/pch\/pxag048\/68524231\/pxag048.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,15]],"date-time":"2026-06-15T04:07:28Z","timestamp":1781496448000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/pch\/advance-article\/doi\/10.1093\/pch\/pxag048\/8707809"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,6,15]]},"references-count":7,"URL":"https:\/\/doi.org\/10.1093\/pch\/pxag048","relation":{},"ISSN":["1205-7088","1918-1485"],"issn-type":[{"value":"1205-7088","type":"print"},{"value":"1918-1485","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,6,15]]},"article-number":"pxag048"}}