Adrenocortical function in children on high-dose steroid aerosol therapy. Results of serum cortisol, ACTH stimulation test and 24 hour urinary free cortical excretion.
The adrenocortical function was investigated in 18 children treated with high-doses of inhaled glucocorticoid aerosol (mean: 1965 micrograms/1.73 m2 body surface a day). Basal serum cortisol was only below the normal range in patients treated with doses exceeding 2500 micrograms/1.73 m2 body surface. 15 of 18 children had normal 24 h urinary free cortisol excretion, compared with 27 normal children matched for age, sex and body surface. Three patients taking more than 2400 micrograms/1.73 m2 body surface showed excretion values below the range for the normal controls. 10 of 12 patients showed a normal response to a short ACTH stimulation test. One patient treated with 3300 micrograms/1.73 m2 body surface showed no response and one patient gave a borderline response to ACTH. We concluded that doses up to 2000 micrograms/1.73 m2 body surface/24 can be administered by pressurized aerosol with little risk of adrenocortical suppression.
University Hospital, Copenhagen, Denmark.
P
P
Prahl
T
T
Jensen
H
H
Bjerregaard-Andersen
D000280:Administration, Inhalation; D000293:Adolescent; D000302:Adrenal Cortex / Q000503:physiopathology*; D001249:Asthma / Q000188:drug therapy* / Q000503:physiopathology; D001507:Beclomethasone / Q000008:administration & dosage; D019819:Budesonide; D002648:Child; D003366:Cosyntropin; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000652:urine; D008297:Male; D011282:Pregnenediones / Q000008:administration & dosage
D005938:Glucocorticoids; D011282:Pregnenediones; D003366:Cosyntropin; D019819:Budesonide; D001507:Beclomethasone; D006854:Hydrocortisone