Treatment of Primary Adrenal Insufficiency in Children (Age Under 18)
Primary adrenal insufficiency (PAI) in paediatric patients requires a management approach tailored to the physiological demands of childhood and adolescence. Treatment must account for the child's age, developmental stage, and individual clinical context.
Clinical Scenario
This protocol covers patients with primary adrenal insufficiency who are under 18 years of age. Children represent a distinct population in which hormone replacement must be calibrated carefully — not only to control symptoms, but to avoid interfering with normal growth and pubertal progression.
Treatment Goals
Treatment is aimed at controlling the symptoms of adrenal insufficiency with a regimen that allows
adequate growth and pubertal development.
Treatment Approach
Management centres on glucocorticoid replacement therapy, adjusted to individual need — with additional specific supplementation considerations depending on the child's clinical presentation and age group.
The full structured regimen, including dosing strategy, monitoring parameters, and age-specific considerations, is available in the complete protocol.
References
DOI: 10.1210/jc.2015-1710
In children with PAI, we suggest treatment with hydrocortisone in three or four divided doses (total starting daily dose of 8 mg/m² body surface area) over other types of glucocorticoid replacement therapies, with doses adjusted according to individual need.
Treatment in children is aimed at controlling the symptoms of adrenal insufficiency with a dose that allows adequate growth and pubertal development.
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