ArticlePediatric allergy, immunology, and pulmonology2017
Adrenal Insufficiency in Pediatric Eosinophilic Esophagitis Patients Treated with Swallowed Topical Steroids.
Article in Pediatric allergy, immunology, and pulmonology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04416217 (Adrenal Suppression in Pediatric Eosinophilic Esophagitis Treated With Topical Steroids - A Multicenter, Prospective, Observational Safety Study), which is not on this map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Adrenal Suppression in Pediatric Eosinophilic Esophagitis Treated With Topical Steroids - A Multicenter, Prospective, Observational Safety Study
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Systematic review: adrenal insufficiency secondary to swallowed topical corticosteroids in eosinophilic oesophagitis.Alimentary pharmacology & therapeutics · 2018Pooled it
- A 12-Week Maintenance Therapy with a New Prepared Viscous Budesonide in Pediatric Eosinophilic Esophagitis.Digestive diseases and sciences · 2019Trial
- Eosinophilic esophagitis in Colombian children: relationship between food allergens, symptoms and endoscopic findings.BMJ paediatrics open · 2026Observational
- Review
- Diagnosis and management of eosinophilic esophagitis.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2024Review
- High prevalence of response to PPI treatment in children and adolescents with eosinophilic esophagitis in southern Brazil.Frontiers in allergy · 2024Article
- Treatment of Pediatric Eosinophilic Esophagitis: Traditional and Novel Therapies.Current gastroenterology reports · 2023Review
- The role of biologics in pediatric food allergy and eosinophilic gastrointestinal disorders.The Journal of allergy and clinical immunology · 2023Review
- Esophageal polyp in a teenage boy with eosinophilic esophagitis.SAGE open medical case reports · 2022Article
- Evidence-based treatments for eosinophilic esophagitis: insights for the clinician.Therapeutic advances in gastroenterology · 2022Review
- Pediatric eosinophilic esophagitis: a review for the clinician.Italian journal of pediatrics · 2021Review
- As Easy as EoE: A Novel and Effective Multidisciplinary Approach to Care of Patients with Eosinophilic Esophagitis in the Age of Biologics.Digestive diseases and sciences · 2020Review
- Eosinophilic Esophagitis: Existing and Upcoming Therapies in an Age of Emerging Molecular and Personalized Medicine.Current allergy and asthma reports · 2020Review
- Eosinophilic esophagitis: Current concepts in diagnosis and treatment.World journal of gastroenterology · 2019Review
- New Developments in the Diagnosis and Treatment of Eosinophilic Esophagitis.Current treatment options in gastroenterology · 2019Review
- Diagnostic and Therapeutic Long-term Management of Eosinophilic Esophagitis- Current Concepts and Perspectives for Steroid Use.Clinical and translational gastroenterology · 2018Review
- Treatment of eosinophilic esophagitis in the pediatric patient: an evidence-based approach.European journal of pediatrics · 2018Review
- Targeting the Interleukin-5 Pathway for Treatment of Eosinophilic Conditions Other than Asthma.Frontiers in medicine · 2018Review
- Low detection of adrenal suppression secondary to swallowed steroids for eosinophilic esophagitis in a quality improvement project.The journal of allergy and clinical immunology. In practiceArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
9 authors at 2 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Swallowed topical steroids (STS) are the only effective pharmacological therapy for eosinophilic esophagitis (EoE). Thus far, studies of small populations of EoE patients have reported conflicting results in relation to adrenal insufficiency (AI). We sought to measure AI in a clinical setting in children taking STS for EoE. We performed a quality improvement study of pediatric EoE patients seen in a multidisciplinary clinic, who were treated with STS for at least 3 months. Two hundred twenty-five patients completed questionnaires to assess for signs of AI. All patients were requested to have fasting morning cortisol levels completed and if abnormal (<5 μg/dL or 139 nmol/L) twice, endocrinology consultation, and low-dose adrenocorticotropic hormone stimulation test were performed. A peak stimulated cortisol level of <18 μg/dL or 500 nmol/L was diagnostic of AI. Five of 106 STS-treated EoE patients who had morning cortisol levels drawn had AI. All 5 of these patients had asthma and were on additional topical steroid treatments. The number of steroid modalities and dose of steroid were not significant risk factors. Despite this low percentage, the life-threatening potential of AI warrants patient screening, as patients with iatrogenic AI are typically asymptomatic until an emergency triggers adrenal crisis. Further multicenter studies are needed to better define the risk attributable to STS alone, particularly in patients receiving combined steroid modalities.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.