title: Cushing syndrome with secondary adrenal insufficiency from concomitant therapy with ritonavir and fluticasone.
abstract: We present 2 cases of Cushing syndrome with secondary adrenal insufficiency from concomitant use of ritonavir and inhaled corticosteroids in children with human immunodeficiency virus infection. These cases highlight the need for special consideration when treatment with an inhaled/intranasal corticosteroid is indicated in children receiving antiretroviral therapy.
authors.affiliation: Division of Infectious Diseases, Department of Pediatrics, University of South Florida College of Medicine, Tampa, 33606, USA. sjohnso2@hsc.usf.edu
authors.forename: Susan R
authors.initials: SR
authors.lastname: Johnson
authors.forename: Alicia A
authors.initials: AA
authors.lastname: Marion
authors.forename: Teri
authors.initials: T
authors.lastname: Vrchoticky
authors.forename: Patricia J
authors.initials: PJ
authors.lastname: Emmanuel
authors.forename: Jorge
authors.initials: J
authors.lastname: Lujan-Zilbermann
mesh_terms: D000280:Administration, Inhalation; D000293:Adolescent; D000309:Adrenal Insufficiency / Q000139:chemically induced*; D000420:Albuterol / Q000008:administration & dosage / Q000009:adverse effects / Q000031:analogs & derivatives; D000730:Androstadienes / Q000008:administration & dosage / Q000009:adverse effects*; D001249:Asthma / Q000188:drug therapy; D001993:Bronchodilator Agents / Q000008:administration & dosage / Q000009:adverse effects*; D002648:Child; D003480:Cushing Syndrome / Q000139:chemically induced*; D004347:Drug Interactions; D004359:Drug Therapy, Combination; D005260:Female; D000068298:Fluticasone; D015658:HIV Infections / Q000188:drug therapy; D017320:HIV Protease Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D019438:Ritonavir / Q000008:administration & dosage / Q000009:adverse effects*; D000068299:Salmeterol Xinafoate
chemical_list: D000730:Androstadienes; D001993:Bronchodilator Agents; D017320:HIV Protease Inhibitors; D000068299:Salmeterol Xinafoate; D000068298:Fluticasone; D019438:Ritonavir; D000420:Albuterol