Daijiworld Media Network - New Delhi

New Delhi, Oct 15: A retrospective observational study at a tertiary pediatric hospital has found that children receiving supraphysiological glucocorticoids for nephrotic syndrome or juvenile idiopathic arthritis face a very low risk of adrenal crisis when therapy is carefully tapered.

The study followed children aged one month to under 16 years over 2,363 patient months, capturing monthly treatment regimens and monitoring for emergency visits, electrolyte imbalances, clinical coding entries, and team reports indicative of adrenal crisis.

During 974 patient months following glucocorticoid discontinuation, no adrenal crisis events were reported. Patients transitioning from daily therapy to alternate day dosing showed a safe profile, suggesting that structured tapering can significantly reduce the risk of clinically significant adrenal suppression.

The findings indicate that, for these pediatric conditions, glucocorticoids may be weaned and stopped safely without routine biochemical testing if supported by specialist pathways. Rapid access to clinical advice for families during illness or stress dosing remains key to safe implementation.

For U.S. pediatric practice, the study supports structured taper protocols, clear family education, and standardized discharge instructions. Routine biochemical testing may be reserved for complex or prolonged cases, while emphasizing vigilance for symptoms and guidance on stress dosing during fever, illness, or surgery.