P NS X JIA X STEROIDS

 A

BGT – Adrenal Crisis Risk After High-Dose Glucocorticoids in NS & JIA

Archives of Disease in Childhood 2025 | Finnie et al.

• Population: Children 1 month–<16 yrs treated with supraphysiological glucocorticoids for:

  • Nephrotic syndrome (NS)

  • Juvenile idiopathic arthritis (JIA)

• Design: Single-centre retrospective study

• Follow-up:

  • 2363 patient-months total

  • 974 patient-months post-GC discontinuation

Key Findings

• Zero adrenal crises (AC) identified during follow-up

• All NS and 15% JIA patients used alternate-day GC during weaning

• No AC after stopping glucocorticoids

• Findings consistent with low AC incidence in other cohorts

Clinical Implications

• Several weeks of supraphysiological GC may be weaned and stopped safely without routine biochemical testing

• Alternate-day weaning may reduce clinically significant adrenal suppression

• Rapid specialist access and safety-netting likely protective

• True AC risk in this population appears very low

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One-Line Tagline

“In NS and JIA, adrenal crisis after high-dose steroid courses appears rare — structured weaning and safety-netting may be enough.”