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A Chinoy Royal Manchester Children’s Hospital, Manchester, UK

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M Skae Royal Manchester Children’s Hospital, Manchester, UK

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A Babiker King Abdullah Specialized Children’s Hospital, Riyadh, Saudi Arabia

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D Kendall Royal Preston Hospital, Preston, UK

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M Z Mughal Royal Manchester Children’s Hospital, Manchester, UK

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R Padidela Royal Manchester Children’s Hospital, Manchester, UK

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on the specific aetiology and genetic mutations. There is scanty information in the medical literature, which describes the impact that intercurrent illness may have on serum cCa concentration in children with HPT. We describe a case series of three

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Kathrin Zopf Department of Endocrinology, Diabetes and Nutrition, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

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Kathrin R Frey Department of Medicine I, Endocrine and Diabetes Unit, University Hospital, University of Würzburg, Würzburg, Germany

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Tina Kienitz Department of Endocrinology, Diabetes and Nutrition, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

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Manfred Ventz Department of Endocrinology, Diabetes and Nutrition, Charité – Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, and Berlin Institute of Health, Berlin, Germany

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Britta Bauer Endocrinology in Charlottenburg, Berlin, Germany

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Marcus Quinkler Endocrinology in Charlottenburg, Berlin, Germany

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need a lifelong glucocorticoid replacement therapy ( 11 , 12 ), which needs to be tailored individually to the daily needs, to stress situations, and intercurrent illnesses such as infectious diseases ( 13 ). This is even more important since the daily

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Margret J Einarsdottir Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden

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Penelope Trimpou Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden

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Gudmundur Johannsson Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden

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Oskar Ragnarsson Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg, Sweden
Wallenberg Center for Molecular and Translational Medicine, University of Gothenburg, Gothenburg, Sweden

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. Administration of GC stress dose Stress dose administration is essential to prevent adrenal crisis and death during intercurrent illness ( 5 , 13 ). In case 3, the patient should have received stress doses of GC directly upon admission. Similarly, in case 5

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Marie Freel Queen Elizabeth University Hospital, Glasgow, UK

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document clearly outlines key points in the recognition and management of a new presentation of adrenal insufficiency as well as clarifying how to alter glucocorticoid therapy in the event of intercurrent illness of medical procedures. The lead author of

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Wiebke Arlt Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
Centre for Endocrinology, Diabetes and Metabolism, Birmingham Health Partners, Birmingham, UK

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the Society for Endocrinology Clinical Committee The Society for Endocrinology, 22 Apex Court, Woodlands, Bradley Stoke, Bristol, UK

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suddenly stopped Failure to observe Sick Day Rule 1 : the need to double daily oral glucocorticoid dose during intercurrent illness with fever that requires bed rest and/or antibiotics Failure to observe Sick Day Rule 2 : the need to administer

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L M Mongioì Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy

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R A Condorelli Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy

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S La Vignera Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy

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A E Calogero Department of Clinical and Experimental Medicine, University of Catania, Catania, Italy

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least in part, the limitations related to conventional glucocorticoid treatment: premature mortality ( 3 ), high frequency of hospitalization for intercurrent illnesses, especially infections ( 3 , 12 ), quality of life impairment ( 13 ), poor

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R Solomon-Zemler Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

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L Basel-Vanagaite Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Raphael Recanati Genetic Institute, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel
Felsenstein Medical Research Center, Petach Tikva, Israel
Pediatric Genetics, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel

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D Steier Day Hospitalization Department, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel

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S Yakar David B. Kriser Dental Center, Department of Basic Science and Craniofacial Biology, New York University College of Dentistry, New York, New York, USA

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E Mel Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel

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M Phillip Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel

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L Bazak Raphael Recanati Genetic Institute, Rabin Medical Center – Beilinson Hospital, Petach Tikva, Israel

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D Bercovich Tel-Hai College, Tel-Hai, Israel

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H Werner Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Shalom and VardaYoran Institute for Human Genome Research, Tel Aviv University, Tel Aviv, Israel

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L de Vries Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
Jesse Z. and Sara Lea Shafer Institute for Endocrinology and Diabetes, Schneider Children’s Medical Center of Israel, Petach Tikva, Israel

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, when symptomatic hypoglycemic events, both fasting and postprandial, occurred. Hypoglycemic episodes occurred almost every day and were not necessarily related to vomiting or intercurrent illness, although they were more frequent when intervals between

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V Guarnotta Dipartimento di Promozione della Salute, Materno – Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy

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C Di Stefano Dipartimento di Promozione della Salute, Materno – Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy

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A Santoro Dipartimento di Promozione della Salute, Materno – Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy

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A Ciresi Dipartimento di Promozione della Salute, Materno – Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy

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A Coppola Dipartimento di Promozione della Salute, Materno – Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy

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C Giordano Dipartimento di Promozione della Salute, Materno – Infantile, Medicina Interna e Specialistica di Eccellenza ‘G. D’Alessandro’ (PROMISE), Sezione di Malattie Endocrine, del Ricambio e della Nutrizione, Università di Palermo, Palermo, Italy

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instructions for treatment in special or emergency situations. Patients treated with DR-HC were instructed to add a rescue dose of HC during an intercurrent illness or stress (5 or 10 mg according to severity of stress and symptoms). Table 2 Dose

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Gregory Knowles Walsall Manor Hospital, Walsall, UK

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Emily Warmington College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK

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Lisa M Shepherd Department of Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK

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Jonathan M Hazlehurst Department of Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
Institute of Applied Health Research, University of Birmingham, Birmingham, UK

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Anne de Bray Department of Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK

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Helena Gleeson Department of Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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Wiebke Arlt Department of Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
Medical Research Council London Institute of Medical Sciences, London, UK

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Alessandro Prete Department of Endocrinology, University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
NIHR Birmingham Biomedical Research Centre, University of Birmingham and University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK

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intercurrent illness, with suspected or confirmed COVID-19 being the second most common reason after general malaise/fatigue (18.5% and 23.7% of all sick day events, respectively). During the year preceding the interview, 18 patients with PAI (11.1%) suffered

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Xi Cao Beijing Diabetes Institute, Beijing Tongren Hospital, Capital Medical University, Beijing, China

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Ming Lu Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China

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Rong-Rong Xie Beijing Diabetes Institute, Beijing Tongren Hospital, Capital Medical University, Beijing, China

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Li-Ni Song Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China

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Wei-Li Yang Beijing Diabetes Institute, Beijing Tongren Hospital, Capital Medical University, Beijing, China

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Zhong Xin Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China

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Guang-Ran Yang Department of Endocrinology, Beijing Tongren Hospital, Capital Medical University, Beijing, China

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Jin-Kui Yang Beijing Diabetes Institute, Beijing Tongren Hospital, Capital Medical University, Beijing, China

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inpatient database. A total of 1135 patients with T2DM were selected. Patients with known thyroid diseases, thyroidectomy, taking medications that might affect thyroid function, pregnancy, malignancy, any acute intercurrent illness, or data severely missing

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