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Evaluation of function and disorders of the adrenal gland in neonates

Korean Journal of Pediatrics 2007;50(3):236-240.
Published online March 15, 2007.
Evaluation of function and disorders of the adrenal gland in neonates
Il Tae Hwang
Department of Pediatrics, College of Medicine, Hallym University, Seoul, Korea
신생아에서의 부신기능 평가와 질환
황일태
한림대학교 의과대학 소아과학교실
Abstract
Majority of sick full term newborns have adequate adrenal cortical function in response to stress. Acutely ill neonates with a basal cortisol level less than 15 g/dL (414 nmol/L) suggest adrenal insufficiency and require function testing of adrenal function. In premature infant, immaturity of hypothalamic-pituitary adrenal axis (HPA axis), may limit the ability to increase cortisol production in response to stress. The response to low dose ACTH and CRH appears to be useful as an additional test of adrenal function. CRH stimulation has been used increasingly in neonates. The ACTH and CRH stimulated cortisol response of more than 17 g/dL (469 nmol/L) indicates a normal response.
Key Words: Hypothalamic-Pituitary-Adrenal Axis , Adrenal insufficiency , Neonates


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