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LETTER TO THE EDITOR
Year : 2013  |  Volume : 17  |  Issue : 1  |  Page : 184-185

Endocrine emergencies in critically-ill patients: Challenges in diagnosis and management: Comment


Department of Pediatrics, ESI PGIMSR and MGM Hospital, Parel, Mumbai, India

Date of Web Publication27-Feb-2013

Correspondence Address:
Preeti Shanbag
Department of Pediatrics, ESI PGIMSR and MGM Hospital, Parel, Mumbai
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2230-8210.107884

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How to cite this article:
Shanbag P. Endocrine emergencies in critically-ill patients: Challenges in diagnosis and management: Comment. Indian J Endocr Metab 2013;17:184-5

How to cite this URL:
Shanbag P. Endocrine emergencies in critically-ill patients: Challenges in diagnosis and management: Comment. Indian J Endocr Metab [serial online] 2013 [cited 2020 May 29];17:184-5. Available from: http://www.ijem.in/text.asp?2013/17/1/184/107884

Sir,

I read with interest the excellent review article on "Endocrine emergencies in critically-ill patients: Challenges in diagnosis and management" by Bajwa and Jindal in the September-October 2012 issue of your journal. [1] The article addressed mainly endocrine emergencies in the adult population. In the pediatric population, one needs to consider both congenital and acquired endocrine disorders, which may present as an emergency. As in adults, diabetic keto-acidosis is the most common endocrine emergency. Persistent hyperinsulinemic hypoglycemia of infancy (PHHI) may be seen in neonates and infants. [2] Besides thyroid storm, one may encounter thyrotoxic periodic paralysis with the patient requiring ventilation at admission. [3] As in adults, adrenal crises are seen with conditions like meningococcemia. Neonates with congenital adrenal hyperplasia (CAH) could present with dehydration and shock. [4] The diagnosis is not difficult in females with CAH who will have ambiguous genitalia but should be also be thought of in males who present with dehydration and salt-wasting. Children with ACTH insensitivity may present at any age with hypotension and hypoglycemic seizures. [5] A careful clinical history maintaining a high index of suspicion for an endocrine problem and aggressive management are required to prevent mortality from endocrine emergencies.

 
   References Top

1.Bajwa SJ, Jindal R. Achalasia-alacrima-ACTH insensitivity syndrome (Triple A syndrome). Indian J Endocrinol Metab 2012;16:722-7.  Back to cited text no. 1
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2.Shanbag P, Pathak A, Vaidya M, Shahid SK. Persistent hyperinsulinemic hypoglycemia of infancy: Successful therapy with nifedipine. Indian J Pediatr 2002;69:271-2.  Back to cited text no. 2
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3.Satam N, More V, Shanbag P, Kalgutkar A. Fatal thyrotoxic periodic paralysis with normokalemia. Indian J Pediatr 2007;74:1041-3.  Back to cited text no. 3
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4.Witchel SF, Azziz R. Congenital adrenal hyperplasia. J Pediatr Adolesc Gynecol 2011;24:116-26.  Back to cited text no. 4
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5.Vaidya M, Kelkar A, Shanbag P, Juvekar M. Achalasia-alacrima-ACTH insensitivity syndrome (Triple A syndrome). Indian J Pediatr 2003;70:343-5.  Back to cited text no. 5
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