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All Journal Paediatrica Indonesiana
Badriul Hegar
Department of Child Health, University of Indonesia Medical School, Cipto Mangunkusumo Hospital
Health Professions Medicine & Pharmacology

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Effect of glucocorticoid therapy on adrenal function in children with acute lymphoblastic leukemia Gita Widyapuri; Djajadiman Gatot; Aman Bakti Pulungan; Badriul Hegar
Paediatrica Indonesiana Vol 54 No 1 (2014): January 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (127.077 KB) | DOI: 10.14238/pi54.1.2014.15-21

Abstract

BackgroundGlucocorticoids play an important role in thetreatment ofacute lymphoblastic leukemia (ALL), but can causeside effects such as suppression of the hypothalamic-pituitaryadrenal (HPA) axis. Suppression of the HPA axis causes adrenal insufficiency, disturbs the cortisol response to stress, and may be a cause of morbidity and mortality in children with ALL.ObjectiveTo evaluate adrenal function in children with ALL afterinduction chemotherapy with high dose glucocorticoids.MethodsThe adrenal function of 20 children with ALL wasevaluated using a standard dose (250 μ g) adrenocorticotropinhormone (ACTH) test performed before and after a 6 week oftreatment with glucocorticoids induction phase chemotherapy,which was followed by a week period tapering off. Adrenalinsuffien cy was defined as blood cortisol level of < 18 μg/dLResultsAdrenal insufficiency was found in 14/20 subjects afterthe induction phase followed by a week period of tapering off.Median cortisol levels pre- and post-stimulation before inductionphase were 14.72 (range 2.0 1- 46. 1) μg/dL and 29.29 (range 21.65 - 55 .15) μg/dL, respectively. Median cortisol levels pre- and poststimulation after induction phase were 5.87 (range 0.2 - 20.53)μg/dL and 10.49 (range 0.33 - 28.69) μg/dL, respectively. Clinicalsigns and symptoms did not differ between those with and withoutadrenal insufficiency.ConclusionOf 20 children with ALL, 14 develop adrenalinsufficiency after a 6-week induction therapy with glucocorticoidsand followed by a week period of tapering off. No specific clinicalsigns and symptoms are identified to be related to the adrenalinsufficiency.
Soy-based infant nutrition: a review Yvan Vandenplas; Badriul Hegar
Paediatrica Indonesiana Vol 54 No 1 (2014): January 2014
Publisher : Indonesian Pediatric Society

Show Abstract | Download Original | Original Source | Check in Google Scholar | Full PDF (85.179 KB) | DOI: 10.14238/pi54.1.2014.62-6

Abstract

Dietary consumption of soy varies worldwide.In Asia, people traditionally consume largequantities of soy, while in Europe, soy is notpart of the traditional or daily eating habits.The USA is a major soy producer. The mean intake ofisoflavones by an adult is 8 - 50 mg/day in Asia but only0.5 - 3.5 mg/day in the Western world.1 The soy intakeof a vegetarian is 3 - 12 mg/day and a vegan achievesan intake of 15-60 mg/day.2In the early 1900s, soy-protein preparationswere the only option for the treatment of cow's milkprotein allergy (CMPA) . The first report of the use ofa soybean -based formula for infants dates from 1909.3Most soy drinks are not enriched with zinc, iron,calcium, phosphorous, methionine, or carnitine. Soydrinks also do not contain soy isolate. Soy productsthat do not fulfill the criteria to be an infant formulaare not adapted for infant feeding.
Co-Authors Aman Bakti Pulungan Djajadiman Gatot Gita Widyapuri Yvan Vandenplas