[Evaluation of the hypothalamo-hypopituitary axis after long-term inhalation corticotherapy for nasal polyposis].
OBJECTIVE
To assess the hypothalamic-pituitary-adrenal (HPA) axis after long-term intranasal corticosteroid treatment in nasal polyposis.


METHODS
A short synacthen test was performed in 24 patients who received the highest dose of inhaled beclomethasone among a population of 392 patients treated for nasal polyposis with inhaled corticosteroid therapy and short-term oral corticosteroids.


RESULTS
Mean yearly dose of oral prednisone administered in short-term treatment was 371 mg/year. The amount of short-term oral prednisone decreased during the treatment. Mean daily dose of inhaled beclomethasone was 2861 micrograms/day, decreasing during treatment. Morning plasma cortisol was normal in all patients before and after stimulation (163 +/- 44 and 1 +/- 60 micrograms/ml respectively). Nolomethasone dose and plasma cortisol level before or after stimulation.


CONCLUSIONS
The high dose of inhaled beclomethasone used to treat nasal polyposis does not affect the HPA axis. Some authors in the literature contest the validity of short synacthen test to detect HPA axis suppression. This test does however detect severe impairments of the HPA axis in outpatients.
Service ORL et Chirurgie cervico-faciale, Hôpital Boucicaut et Hôpital Européen Georges Pompidou, Faculté Necker Enfants malades, Université René Descartes, Paris.
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Amanou
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Avan
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Valcke
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Bonfils
D000280:Administration, Inhalation; D000284:Administration, Oral; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D001507:Beclomethasone / Q000008:administration & dosage*; D003366:Cosyntropin; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007030:Hypothalamo-Hypophyseal System / Q000187:drug effects* / Q000502:physiology; D008297:Male; D008875:Middle Aged; D009298:Nasal Polyps / Q000188:drug therapy*; D011241:Prednisone / Q000008:administration & dosage; D012044:Regression Analysis; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D003366:Cosyntropin; C006418:adrenocorticotropin zinc; D001507:Beclomethasone; D011241:Prednisone; D006854:Hydrocortisone