title: Iatrogenic Cushing's syndrome following short-term intranasal steroid use.
abstract: Cushing's syndrome (CS) is common after oral steroid use and has also been reported following topical or inhaled use, but it is extremely uncommon after intranasal administration. In this paper, we present the case of a child who developed CS after intranasal application of combined moxifloxacin-dexamethasone eye drops for epistaxis for a period of 3 months. CS caused by ocular preparations of steroids has not been reported previously. This case report highlights the fact that even eye drops can contain high doses of steroids and can lead to CS especially in children and especially if used intranasally. Ocular steroid drops should not be used intranasally. To minimize gastrointestinal absorption and therefore the risk of CS, nasal sprays should be preferred over nasal drops for intranasal steroid application.
authors.affiliation: IPGMER & SSKM Hospital, Department of Endocrinology & Metabolism, Kolkata, India. deepdutta2000@yahoo.com
authors.forename: Deep
authors.initials: D
authors.lastname: Dutta
authors.forename: K S
authors.initials: KS
authors.lastname: Shivaprasad
authors.forename: Sujoy
authors.initials: S
authors.lastname: Ghosh
authors.forename: Satinath
authors.initials: S
authors.lastname: Mukhopadhyay
authors.forename: Subhankar
authors.initials: S
authors.lastname: Chowdhury
mesh_terms: D000281:Administration, Intranasal; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D001372:Aza Compounds / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D003480:Cushing Syndrome / Q000139:chemically induced* / Q000150:complications; D003907:Dexamethasone / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D004338:Drug Combinations; D004844:Epistaxis / Q000150:complications / Q000188:drug therapy; D005260:Female; D024841:Fluoroquinolones; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D007049:Iatrogenic Disease; D007194:India; D000077266:Moxifloxacin; D009883:Ophthalmic Solutions / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use; D063487:Prescription Drug Misuse; D011804:Quinolines / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use
chemical_list: D000890:Anti-Infective Agents; D001372:Aza Compounds; D004338:Drug Combinations; D024841:Fluoroquinolones; D005938:Glucocorticoids; D009883:Ophthalmic Solutions; D011804:Quinolines; D003907:Dexamethasone; D000077266:Moxifloxacin