title: Growth and adrenal suppression in asthmatic children treated with high-dose fluticasone propionate.
abstract: BACKGROUND
  Fluticasone propionate was introduced in 1993 in the UK as a potentially safer inhaled corticosteroid than those already in use. The efficacy and safety of fluticasone has been established at recommended doses of 200 micrograms/day, but not at higher doses that are often used.
  
  
  METHODS
  Growth retardation was observed in six severely asthmatic children after introduction of high-dose fluticasone propionate treatment (dry powder). Assessment of cortisol response was by insulin-induced hypoglycaemia in three cases, by short tetracosactrin test in two, and by low-dose tetracosactrin and 24-hour urinary cortisol/creatinine ratio in one.
  
  
  RESULTS
  Six children with growth retardation noted after treatment with high-dose fluticasone propionate were found to have adrenal suppression. In one case the growth rate and cortisol response returned to normal 9 months after the fluticasone dose was reduced to 500 micrograms/day.
  
  
  CONCLUSIONS
  When high doses of fluticasone propionate are used, growth may be retarded and adrenal suppression may occur.
authors.affiliation: Antrim Hospital, UK.
authors.forename: G
authors.initials: G
authors.lastname: Todd
authors.forename: K
authors.initials: K
authors.lastname: Dunlop
authors.forename: J
authors.initials: J
authors.lastname: McNaboe
authors.forename: M F
authors.initials: MF
authors.lastname: Ryan
authors.forename: D
authors.initials: D
authors.lastname: Carson
authors.forename: M D
authors.initials: MD
authors.lastname: Shields
mesh_terms: D000287:Administration, Topical; D000302:Adrenal Cortex / Q000187:drug effects*; D000730:Androstadienes / Q000008:administration & dosage* / Q000009:adverse effects*; D018927:Anti-Asthmatic Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects*; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D003864:Depression, Chemical; D005260:Female; D000068298:Fluticasone; D005938:Glucocorticoids; D006130:Growth Disorders / Q000139:chemically induced*; D006801:Humans; D008297:Male
chemical_list: D000730:Androstadienes; D018927:Anti-Asthmatic Agents; D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D000068298:Fluticasone