{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:21:53Z","timestamp":1787840513716,"version":"build-2784847793"},"reference-count":16,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","license":[{"start":{"date-parts":[[2025,7,1]],"date-time":"2025-07-01T00:00:00Z","timestamp":1751328000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Glucocorticoid-induced adrenal insufficiency (AI) is underestimated and under-reported in children with nephrotic syndrome (NS). This study aimed to estimate the prevalence of AI in children with steroid-sensitive NS, defined by serum cortisol level &lt;18 mcg\/dL 30 minutes after low-dose adrenocorticotropin stimulation test (LDST) and\/or baseline (8 AM) serum cortisol level &lt;5 mcg\/dL, 4\u201312 weeks after stopping steroid therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>In this cross-sectional study, 73 children with steroid-sensitive NS, in remission and off steroids for 4\u201312 weeks, were enrolled from the Paediatrics Department at a tertiary care hospital. Baseline (8 AM) serum cortisol was measured, and LDST was done using 1 mcg tetracosactide acetate intravenously. The proportion of AI was calculated. Clinical features of AI and steroid toxicity were noted, and the association between the two was analysed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Out of 73 children (45 males), 52 (71.2%, 95% confidence interval: 59.3%\u201380.9%) had AI as defined by serum cortisol level &lt;18 mcg\/dL 30 min after LDST and\/or baseline (8 AM) serum cortisol level &lt;5 mcg\/dL at 4\u201312 weeks after completion of steroid therapy. A strong positive correlation was observed between 8 AM baseline serum cortisol levels and post-LDST serum cortisol levels. Children exhibiting features of steroid toxicity, such as cushingoid facies, had 4.96 times higher odds of having AI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>There remains a high risk of AI even 4\u201312 weeks after completion of alternate-day steroid therapy in children with NS. Clinical features of steroid toxicity may serve as useful predictors of AI.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijem.ijem_12_25","type":"journal-article","created":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T07:00:32Z","timestamp":1756278032000},"page":"423-428","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":0,"title":["Adrenal Insufficiency after Steroid Therapy in Children with Steroid-Sensitive Nephrotic Syndrome: A Cross-sectional Study"],"prefix":"10.4103","volume":"29","author":[{"given":"Anoushka","family":"Kapila","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Endocrinology and Metabolism, University College of Medical Sciences and Guru Teg Bahadur Hospital, New Delhi, India"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaradhana","family":"Singh","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Endocrinology and 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