Symptomatic glucocorticoid-induced adrenal suppression in the United Kingdom and Ireland: a BPSU study
Bibliographic record
Abstract
OBJECTIVE: To determine the incidence and describe the presentation and management of unexpected symptomatic glucocorticoid-induced adrenal suppression (AS) in children and young people aged 0-15 years. SETTING AND DESIGN: Surveillance study of symptomatic glucocorticoid (GC)-induced AS with supportive biochemical evidence or presenting as an adrenal crisis, reported via the British Paediatric Surveillance Unit (BPSU) from September 2020 to September 2022. RESULTS: Over a 25-month period, 190 reports of symptomatic GC-induced AS/adrenal crisis were made, of which 22 were confirmed cases: 18 AS and 4 adrenal crises. This translates to an incidence rate of 0.09 new cases of GC-induced AS per 100 000 children aged 0-15 per year in the UK. There was a broad range of underlying diagnoses requiring GC prescription (16) and GC preparations (13). Of the 22 patients, 7 had more than 1 type of GC prescribed. The administration of oral GC occurred in 19 of the cases, inhaled GC use in 7, topical use in 5 and 1 case occurred after a single intramuscular injection of GC. All patients were discussed with a paediatric endocrinology team. CONCLUSIONS: The incidence of AS from this UK-based BPSU study is lower than a similar Canadian study. This may indicate that paediatricians in the UK and Ireland are becoming more aware of the potential for GC-induced AS and thus are more proactive to prevent its occurrence. The clinical cases still highlight the need to educate families and healthcare professionals with a view to further reducing the morbidity and potential mortality associated with GC-induced AS.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".