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Patel, L.; Wales, J.K.H.; Kibirige, M.S.; Massarano, A.A.; Couriel, J.M.; Clayton, P.E. (2001)
Languages: English
Types: Article

Classified by OpenAIRE into

mesheuropmc: hormones, hormone substitutes, and hormone antagonists
Symptomatic adrenal insufficiency, presenting\ud as hypoglycaemia or poor weight\ud gain, may occur on withdrawal of corticosteroid\ud treatment but has not previously\ud been reported during inhaled corticosteroid\ud treatment. This case series illustrates\ud the occurence of clinically\ud significant adrenal insufficiency in asthmatic\ud children while patients were on\ud inhaled corticosteroid treatment and the\ud unexpected modes of presentation. General\ud practitioners and paediatricians need\ud to be aware that this unusual but acute\ud serious complication may occur in patients\ud treated.
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    • 4 Duplantier JE, Nelson RP, Morelli AR, et al. Hypothalamicpituitary-adrenal axis suppression associated with the use of inhaled fluticasone propionate. J Allergy Clin Immunol 1998;102:699-700.
    • 5 Zwaan CM, Odink RJH, Delemarre-van de Waal HA, Dankert-Roelse JE. Acute adrenal insuYciency after discontinuation of inhaled corticosteroid therapy. Lancet 1992;340:1289-90.
    • 6 The British Guidelines on Asthma Management. 1995 Review and Position Statement. Thorax 1997;52(suppl 1):S1-S21.
    • 7 Chrousos GP, Harris AG. Hypothalamic-pituitary-adrenal axis suppression and inhaled corticosteroid therapy. 2. Review of literature. Neuroimmunomodulation 1998;5:288- 308.
    • 8 Thomas BC, Stanhope R, Grant DB. Impaired growth in children with asthma during treatment with conventional doses of inhaled corticosteroids. Acta Paediatr 1994;83: 196-9.
    • 9 Zimmerman B, Gold M, Wherrett D, Hanna AK. Adrenal suppression in two patients with asthma treated with low doses of the inhaled steroid fluticasone propionate. J Allergy Clin Immunol 1998;101:425-6.
    • 10 Ebrecht M, Buske-Kirschbaum A, Hellhammer D, et al. Tissue specificity of glucocorticoid sensitivity in healthy adults. J Clin Endocrinol Metab 2000;85:3733-9.
    • 11 Panarelli M, Holloway CD, Fraser R, et al. Glucocorticoid receptor polymorphism, skin vasoconstriction, and other metabolic intermediate phenotypes in normal human subjects. J Clin Endocrinol Metab 1998;83:1846-52.
    • 12 Walker BR, Best R, Shackleton CH, et al. Increased vasoconstrictor sensitivity to glucocorticoids in essential hypertension. Hypertension 1996;27:190-6.
    • 13 Barnes PJ, Adcock IM. Steroid resistance in asthma. Q J Med 1995;88:455-68.
    • England in 1998, 8.43 million NHS prescriptions were filled for beclomethasone, compared to only 1.88 million for budesonide and 1.54 million for fluticasone.17 We too are cautious in our interpretation of these proportions, but await with interest further reports of ICS related adrenal suppression.
    • 1 Anonymous. Inhaled corticosteroids compared with oral prednisone in patients starting long-term corticosteroid therapy for asthma. A controlled trial by the British Thoracic and Tuberculosis Association. Lancet 1975;2: 469-73.
    • 2 Kershnar H, Klein R, Waldman D, et al. Treatment of chronic childhood asthma with beclomethasone dipropionate aerosols: II. EVect on pituitary-adrenal function after substitution for oral corticosteroids. Pediatrics 1978;62:189-97.
    • 3 Stiksa G, Nemcek K, Glennow C. Adrenal function in asthmatics treated with high-dose budesonide. Respiration 1985;48:91-3.
    • 4 Mellis CM, Phelan PD. Asthma deaths in children-a continuing problem. Thorax 1977;32:29-34.
    • 5 Covar RA, Leung DY, McCormick D, et al. Risk factors associated with glucocorticoid-induced adverse eVects in children with severe asthma. J Allergy Clin Immunol 2000;106:651-9.
    • 6 Turpeinen M, Sorva R, Juntunen-Backman K. Changes in carbohydrate and lipid metabolism in children with asthma inhaling budesonide. J Allergy Clin Immunol 1991;88:384-9.
    • 7 Kruszynska YT, Greenstone M, Home PD, Cooke NJ. EVect of high dose inhaled beclomethasone dipropionate on carbohydrate and lipid metabolism in normal subjects. Thorax 1987;42:881-4.
    • 8 Kiviranta K, Turpeinen M. EVect of eight months of inhaled beclomethasone dipropionate and budesonide on carbohydrate metabolism in adults with asthma. Thorax 1993;48: 974-8.
    • 9 Brown HM. Nocturnal adrenal suppression in children inhaling beclomethasone dipropionate. Lancet 1986;1: 1269.
    • 10 Law CM, Marchant JL, Honour JW, et al. Nocturnal adrenal suppression in asthmatic children taking inhaled beclomethasone dipropionate. Lancet 1986;i:942-4.
    • 11 Bisgaard H, Damkjaer NM, Andersen B, et al. Adrenal function in children with bronchial asthma treated with beclomethasone dipropionate or budesonide. J Allergy Clin Immunol 1988;81:1088-95.
    • 12 Pedersen S, Fuglsang G. Urine cortisol excretion in children treated with high doses of inhaled corticosteroids: a comparison of budesonide and beclomethasone. Eur Respir J 1988;1:433-5.
    • 13 Lipworth BJ. Systemic adverse eVects of inhaled corticosteroid therapy: a systematic review and meta-analysis. Arch Intern Med 1999;159:941-55.
    • 14 Clark DJ, Clark RA, Lipworth BJ. Adrenal suppression with inhaled budesonide and fluticasone propionate given by large volume spacer to asthmatic children. Thorax 1996;51: 941-3.
    • 15 Brutsche MH, Brutsche IC, Munawar M, et al. Comparison of pharmacokinetics and systemic eVects of inhaled fluticasone propionate in patients with asthma and healthy volunteers: a randomised crossover study. Lancet 2000;356: 556-61.
    • 16 Weiner P, Berar-Yanay N, Davidovich A, Magadle R. Nocturnal cortisol secretion in asthmatic patients after inhalation of fluticasone propionate. Chest 1999;116: 931-4.
    • 17 http://www.doh.gov.uk/pdfs/pca98.pdf
    • 18 Helms PJ. Corticosteroid-sparing options in the treatment of childhood asthma. Drugs 2000;59(suppl 1):15-22.
    • 19 British Thoracic Society, National Asthma Campaign, Royal College of Physicians of London, et al. The British Guidelines on Asthma Management. 1995 Review and Position Statement. Thorax 1997;52:S1-S20.
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