Glucocorticoid Withdrawal – Heterozygous Carriers of Congenital Adrenal Hyperplasia at Risk?

Introduction

High dose glucorticoid therapy is an integral component of numerous pediatric treatment schemes e. g. for chronic inflammative, neurological or haematooncological disorders. To prevent iatrogenic Addisonian crisis gradual dose reduction is usually conducted. If clinical signs of adrenal insufficiency occur despite tapering, hydrocortisone substitution is frequently initiated following a purely pragmatic approach without further etiological assessment.