Clinical spectrum and outcomes of adrenal gland disorders in children: insights from a tertiary care cohort in India

Abstract

Background: Pediatric adrenal disorders, including acute and chronic insufficiency, adrenocortical tumors, and pheochromocytoma, are rare but carry significant morbidity and mortality. There is limited region-specific data from India. Objective: To characterize clinical features, management, and short-term outcomes of adrenal gland diseases in Indian children. Methods: Retrospective analysis of children (≤18 years) diagnosed with adrenal disorders at a tertiary center from 2010–2024. Clinical, biochemical, imaging, histopathology, and outcome data were analyzed. Results: Among 78 children, acute adrenal crises were prominent in classical primary adrenal insufficiency, non-CAH etiologies included adrenoleukodystrophy and autoimmune causes, while 16% had adrenocortical tumors and 12% pheochromocytoma. Genetic testing aided etiologic diagnosis in >70% of insufficiency cases. Surgical management of tumors showed favorable outcomes in benign pathology but guarded prognosis in carcinoma. Conclusion: Adrenal disorders in Indian children present with diverse features. Early diagnosis, genetic evaluation, and structured multidisciplinary care improve outcomes.