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Jefferson P. Lomenick, MD; Kent L. Reifschneider, MD; Anne W. Lucky, MD; Denise Adams, MD; Richard G. Azizkhan, MD; Jessica G. Woo, PhD; Philippe F. Backeljauw, MD

Arch Dermatol. 2009;145(3):262-266.

Objective  To determine the prevalence of adrenal insufficiency in infants with hemangiomas following treatment with systemic glucocorticoids (GCs).

Design  Prospective study for 18 months.

Setting  Hemangioma and vascular malformation center at a tertiary care children's hospital.

Patients  Sixteen infants with hemangiomas had an adrenal axis evaluation as soon as possible following the completion of GC therapy. Ten healthy control infants were also evaluated for comparison.

Interventions  Prednisolone at a starting dose of 2 to 3 mg/kg/d for 4 weeks, followed by a tapering period. The mean duration of GC treatment was 7.2 months.

Main Outcome Measure  Prevalence of adrenal insufficiency in GC-treated subjects as assessed by a combination low-dose/high-dose corticotropin stimulation test.

Results  Subjects underwent corticotropin testing at a mean of 13 days after the completion of therapy. Only 1 of the 16 GC-treated infants (6%) had adrenal insufficiency. This subject was tested 1 day after GC treatment was stopped, and results from retesting 3 months later were normal. All control subjects had normal adrenal function.

Conclusion  Infants with hemangiomas are at low risk of adrenal insufficiency following the completion of GC therapy, as used in our hemangioma center.

Author Affiliations: Division of Endocrinology (Drs Lomenick, Reifschneider, and Backeljauw), Hemangioma and Vascular Malformation Center (Drs Lucky, Adams, and Azizkhan), and Center for Epidemiology and Biostatistics (Dr Woo), Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio.

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