Alkindi Sprinkle for Pediatric Patients With Primary Adrenocortical Insufficiency: A Narrative Review

Authors

Alan D. Kaye, Louisiana State University Health Sciences Center, Shreveport, LA
Munira E. Khaled, Louisiana State University Health Sciences Center, Shreveport, LA
Kristin Nicole Bembenick, Louisiana State University Health Sciences Center, Shreveport, LA
John Lacey, LSU Health Sciences Center - New OrleansFollow
Anamika Tandon, LSU Health Sciences Center - New OrleansFollow
Rucha A. Kelkar, Medical University of South Carolina, Charleston, SC
Alyssa G. Derouen, Louisiana State University Health Sciences Center, Shreveport, LA
Corrado Ballaera, Louisiana State University Health Sciences Center, Shreveport, LA
Debbie Chandler, Louisiana State University Health Sciences Center, Shreveport, LA
Shahab Ahmadzadeh, Louisiana State University Health Sciences Center, Shreveport, LA
Sahar Shekoohi, Louisiana State University Health Sciences Center, Shreveport, LA
Giustino Varrassi, Paolo Procacci Foundation, Rome, ITA

Document Type

Article

Publication Date

3-12-2024

Publication Title

Cureus

Abstract

Adrenocortical insufficiency, also known as adrenal insufficiency (AI), is an endocrine disorder characterized by inadequate production of adrenal hormones, including glucocorticoids and mineralocorticoids (MCs). The condition can be categorized as primary, secondary, or tertiary AI, depending on the location of the defect. Classical symptoms of AI include weakness, fatigue, abdominal pain, tachycardia, hypotension, electrolyte imbalances, and hyperpigmentation. In children, the most common cause of AI is classical congenital adrenal hyperplasia, which results from a deficiency in the 21-hydroxylase enzyme. The 21-hydroxylase enzyme produces all steroids, such as cortisol and aldosterone. AI management primarily involves hormone replacement therapy, typically with oral hydrocortisone and MC supplementation. However, the administration of hydrocortisone to pediatric patients presents challenges related to the lack of available dose-appropriate formulations. Historically, crushed or split adult tablets were used for the pediatric treatment of AI, although this poses an increased risk of under- or overtreatment. Inadequate dosing in the pediatric population can adversely affect growth, development, and metabolic health. Alkindi Sprinkle is a pediatric-specific hydrocortisone oral granule preparation that manages cortisol levels to help facilitate accurate therapeutic dosing. Alkindi offers several advantages, including accurate dosing, taste masking, and ease of administration. The present investigation describes AI, the management of AI, and the treatment of pediatric AI using Alkindi Sprinkle, including clinical efficacy.

First Page

e56031

PubMed ID

38606228

Volume

16

Issue

3

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Recommended Citation

Kaye, Alan D.; Khaled, Munira E.; Bembenick, Kristin Nicole; Lacey, John; Tandon, Anamika; Kelkar, Rucha A.; Derouen, Alyssa G.; Ballaera, Corrado; Chandler, Debbie; Ahmadzadeh, Shahab; Shekoohi, Sahar; and Varrassi, Giustino, "Alkindi Sprinkle for Pediatric Patients With Primary Adrenocortical Insufficiency: A Narrative Review" (2024). School of Medicine Faculty Publications. 2491.
https://digitalscholar.lsuhsc.edu/som_facpubs/2491
10.7759/cureus.56031