title: A case of iatrogenic growth retardation induced by a corticosteroid-containing anti-allergic drug.
abstract: 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.
authors.affiliation: Second Department of Internal Medicine, Kansai Medical University, Osaka, Japan.
authors.forename: M
authors.initials: M
authors.lastname: Nishikawa
authors.forename: M
authors.initials: M
authors.lastname: Hikosaka
authors.forename: T
authors.initials: T
authors.lastname: Yonemoto
authors.forename: A
authors.initials: A
authors.lastname: Gondou
authors.forename: S
authors.initials: S
authors.lastname: Tabata
authors.forename: Y
authors.initials: Y
authors.lastname: Ogawa
authors.forename: M
authors.initials: M
authors.lastname: Kanasaki
authors.forename: Y
authors.initials: Y
authors.lastname: Miyake
authors.forename: H
authors.initials: H
authors.lastname: Shimizu
authors.forename: A
authors.initials: A
authors.lastname: Shouzu
mesh_terms: 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
chemical_list: D015065:17-Hydroxycorticosteroids; D018926:Anti-Allergic Agents; D005938:Glucocorticoids; D002744:Chlorpheniramine; D001623:Betamethasone; D006854:Hydrocortisone