Adrenal crises in children treated with high-dose inhaled corticosteroids for asthma.
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.
Macdessi
Joseph S
JS
Department of Respiratory Medicine, The Children's Hospital at Westmead, Locked Bag 4001, Westmead, NSW 2145, Australia. josephm@chw.edu.au
Randell
Tabitha L
TL
Donaghue
Kim C
KC
Ambler
Geoffrey R
GR
van Asperen
Peter P
PP
Mellis
Craig M
CM
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
D000305:Adrenal Cortex Hormones; D006854:Hydrocortisone