title: Adrenal suppression following intralesional corticosteroids for periocular haemangiomas.
abstract: OBJECTIVE
  Treatment with intralesional triamcinolone/betamethasone is recommended for infantile sight-threatening periocular haemangiomas. This study investigates the endocrine and weight changes in 15 infants undergoing therapy over 12 years.
  
  
  METHODS
  15 infants, median age 19 weeks (range 10-56) receiving intra/perilesional triamcinolone/betamethasone underwent serial measurement of weight, early morning serum cortisol and adrenocorticotropic hormone (ACTH) before and after injection.
  
  
  RESULTS
  Cortisol fell from a median (range) of 383 (112-594) to 28 (<10-506) nmol/l (p=0.005) and ACTH from 26 (14-134) to 9 (5-20) ng/l (p=0.05) from before injection to 4 weeks after treatment. Prolonged adrenal suppression occurred in 13 out of 15 cases with time to recovery being 19.5 (4-65) weeks. Failure to gain weight appropriately was observed in 14 infants but recovered once normal adrenal function was re-established.
  
  
  CONCLUSIONS
  Prolonged adrenal suppression following triamcinolone/betamethasone injection for periocular haemangiomas is common and associated with faltering weight gain.
authors.affiliation: University Hospital of Wales, Heath Park, Cardiff, UK.
authors.forename: C
authors.initials: C
authors.lastname: Morkane
authors.forename: J W
authors.initials: JW
authors.lastname: Gregory
authors.forename: P
authors.initials: P
authors.lastname: Watts
authors.forename: J T
authors.initials: JT
authors.lastname: Warner
mesh_terms: D000309:Adrenal Insufficiency / Q000097:blood / Q000139:chemically induced*; D000324:Adrenocorticotropic Hormone / Q000097:blood; D001623:Betamethasone / Q000008:administration & dosage / Q000009:adverse effects; D002675:Child, Preschool; D004338:Drug Combinations; D005142:Eyelid Neoplasms / Q000188:drug therapy*; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006391:Hemangioma / Q000188:drug therapy*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D007223:Infant; D015552:Injections, Intralesional; D008297:Male; D012189:Retrospective Studies; D014221:Triamcinolone / Q000008:administration & dosage / Q000009:adverse effects; D015430:Weight Gain / Q000187:drug effects
chemical_list: D004338:Drug Combinations; D005938:Glucocorticoids; D014221:Triamcinolone; D000324:Adrenocorticotropic Hormone; D001623:Betamethasone; D006854:Hydrocortisone