Hypoglycemia due to adrenal suppression secondary to high-dose nebulized corticosteroid.
High-dose inhaled corticosteroids, greater than 400 mcg per day of beclomethasone dipropionate or equivalent, can cause adrenal insufficiency, but a hypoglycemic crisis has not been reported with the use of nebulized corticosteroids. We describe a 21-month-old asthmatic boy who had a hypoglycemic seizure during a proven acute adrenal crisis secondary to high-dose nebulized budesonide treatment.
Dunlop
K A
KA
Royal Belfast Hospital for Sick Children, Belfast, Northern Ireland, UK.
Carson
D J
DJ
Shields
M D
MD
D000280:Administration, Inhalation; D000302:Adrenal Cortex / Q000187:drug effects; D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D001249:Asthma / Q000097:blood / Q000150:complications* / Q000188:drug therapy; D001993:Bronchodilator Agents / Q000009:adverse effects*; D019819:Budesonide / Q000009:adverse effects*; D006801:Humans; D006854:Hydrocortisone / Q000627:therapeutic use; D007003:Hypoglycemia / Q000097:blood / Q000209:etiology*; D007223:Infant; D008297:Male; D009330:Nebulizers and Vaporizers
D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D001993:Bronchodilator Agents; D019819:Budesonide; D006854:Hydrocortisone