The CRUNCH study version 1

  • Research type

    Research Study

  • Full title

    Cortisol Response to acute, febrile illness in children and young people

  • IRAS ID

    358020

  • Contact name

    Joanne Blair

  • Contact email

    jo.blair@alderhey.nhs.uk

  • Sponsor organisation

    Alder Hey Children's NHS Foundation Trust

  • Duration of Study in the UK

    0 years, 3 months, 1 days

  • Research summary

    Cortisol is a hormone that has an essential role in maintaining good health. We release a small amount of cortisol during periods of good health, and higher amounts of cortisol during periods of ill health or injury to help recovery.
    Some people cannot produce enough cortisol, and they take a medicine form of cortisol called hydrocortisone every day. When they are ill or injured, they take higher 'sick day' doses of hydrocortisone.
    Current guidelines for the types of illness that need to be treated with sick day doses, and the doses of hydrocortisone that should be prescribed, are based on experts' advice because no one has described what types of illness trigger an increase in cortisol release in healthy children, and how much cortisol is released. This means that sick day doses could be too high or too low or recommended when they are not required. If the dose is too low, patients could experience a life-threatening condition, ‘adrenal crisis’. If the dose is too high, or given more often than required, high levels of cortisol may contribute to the development of heart and bone disease over a patient’s lifetime.
    In this study, we will learn how much cortisol children without adrenal insufficiency release when they are sick. To do this, we will invite children and young people to collect five saliva samples while they are unwell with a mild / moderate illness, and four when they have recovered fully. Saliva samples can be collected while they are in hospital or at home and posted to Alder Hey in a stamped addressed envelope. We will compare the cortisol levels measured during ill health and good health to determine whether sick day doses are required during these episodes, and how much hydrocortisone should be prescribed.

  • REC name

    West of Scotland REC 5

  • REC reference

    25/WS/0125

  • Date of REC Opinion

    27 Aug 2025

  • REC opinion

    Further Information Favourable Opinion