title: Adrenal crises in children treated with high-dose inhaled corticosteroids for asthma.
abstract: Three children presented with adrenal crises, manifested by vomiting and hypoglycaemia, after protracted courses of high-dose inhaled corticosteroids for asthma. Significant dose reduction was possible in all three without loss of asthma control, emphasising the importance of back-titration to minimise dose. Parents of children taking high doses of inhaled corticosteroids should be alerted to the clinical features of adrenal insufficiency. If suspected, prompt medical assessment should be arranged, including serum glucose and cortisol measurement.
authors.affiliation: Department of Respiratory Medicine, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia. josephm@chw.edu.au
authors.forename: Joseph S
authors.initials: JS
authors.lastname: Macdessi
authors.forename: Tabitha L
authors.initials: TL
authors.lastname: Randell
authors.forename: Kim C
authors.initials: KC
authors.lastname: Donaghue
authors.forename: Geoffrey R
authors.initials: GR
authors.lastname: Ambler
authors.forename: Peter P
authors.initials: PP
authors.lastname: van Asperen
authors.forename: Craig M
authors.initials: CM
authors.lastname: Mellis
mesh_terms: D000305:Adrenal Cortex Hormones / Q000009:adverse effects*; D000309:Adrenal Insufficiency / Q000139:chemically induced*; D001249:Asthma / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007003:Hypoglycemia / Q000139:chemically induced; D008297:Male; D014839:Vomiting / Q000139:chemically induced
chemical_list: D000305:Adrenal Cortex Hormones; D006854:Hydrocortisone