ArticleEndocrine2026
Survey of Adrenal Insufficiency Management for Duchenne muscular dystrophy in Italy.
Article in Endocrine, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
What it found
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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.
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Who cites it
1 citing paper in PubMed.
- A Multidisciplinary Approach to the Anesthetic Management of Patients With Duchenne Muscular Dystrophy.Pediatric pulmonology · 2026Review
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Authors and funding
7 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThe aim of this study was to evaluate current real-world practices for the prevention and management of adrenal insufficiency (AI) among Italian physicians caring for children and adolescents with Duchenne muscular dystrophy (DMD) receiving chronic glucocorticoid (GC) therapy, a treatment known to improve motor and cardiopulmonary outcomes but to suppress the hypothalamic–pituitary–adrenal axis and increase the risk of adrenal crisis.
methodsA cross-sectional online survey was distributed via national networks to Italian pediatric endocrinologists and neuromuscular specialists. The questionnaire explored clinician characteristics, patient caseloads, glucocorticoid regimens, stress-dose recommendations for mild, moderate, and severe illness, and proactive measures such as family education, emergency kits, written plans, medical alert identification, and electronic hospital alerts. Participation was anonymous.
resultsThirty-five clinicians responded (57% pediatric endocrinologists, 43% neuromuscular specialists), most following 11–50 patients. Deflazacort was the predominant treatment (86%). For mild stress, 80% advised no additional GC. For moderate stress, 43% recommended no change to management, 31% provided oral hydrocortisone (HC), 17% advised extra daily GC, and 9% prescribed intramuscular HC. For severe stress, although 77% prescribed parenteral HC, 14% advised no change. Proactive measures were inconsistently implemented: 82% provided family education, 43% gave intramuscular HC prescriptions and training, 71% had written emergency plans, and 31% recommended medical alert identification.
conclusionsThis national survey reveals substantial variability and gaps in AI prevention and management for children and adolescents with DMD on chronic GC therapy in Italy. Harmonized national protocols, multidisciplinary coordination, and strengthened family education are needed to improve adrenal crisis prevention.
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