A case of iatrogenic growth retardation induced by a corticosteroid-containing anti-allergic drug.
A nine-year old boy developed reduced growth velocity at the age of seven. The peak plasma growth hormone (GH) response to 3,4-dihydroxyphenylalanine, GH-releasing factor and insulin was 10.2, 8.1 and 7.6 micrograms/l, respectively, suggesting that the GH reserve was slightly reduced. Serum cortisol was undetectable and urinary excretion of 17-hydroxycorticosteroid was low (0.22-0.31 mg/day), but there were no physical or biochemical signs of adrenocortical insufficiency. He had taken an anti-allergic drug containing 0.25 mg of betamethasone and 2 mg of d-chlorpheniramine maleate per tablet for about 2 years to treat allergic rhinitis. Catch-up growth occurred when this drug was stopped. The present case suggests that daily administration of 0.25 mg of betamethasone can induce growth retardation and that ingestion of corticosteroid-containing preparations needs to be excluded in children who develop short stature without other symptoms.
Nishikawa
M
M
Second Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
Hikosaka
M
M
Yonemoto
T
T
Gondou
A
A
Tabata
S
S
Ogawa
Y
Y
Kanasaki
M
M
Miyake
Y
Y
Shimizu
H
H
Shouzu
A
A
D015065:17-Hydroxycorticosteroids / Q000652:urine; D018926:Anti-Allergic Agents / Q000009:adverse effects* / Q000627:therapeutic use; D001623:Betamethasone / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002744:Chlorpheniramine / Q000009:adverse effects* / Q000627:therapeutic use; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006130:Growth Disorders / Q000139:chemically induced* / Q000175:diagnosis; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007049:Iatrogenic Disease; D008297:Male; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy
D015065:17-Hydroxycorticosteroids; D018926:Anti-Allergic Agents; D005938:Glucocorticoids; D002744:Chlorpheniramine; D001623:Betamethasone; D006854:Hydrocortisone