title: Moderate Dose Inhaled Budesonide Disguising Symptoms of Addison's Disease in An Asthmatic Boy with Silent Celiac Disease.
abstract: Inhaled corticosteroids are first-line treatment for asthma. Moderate doses of budesonide have been supposed not to affect hypothalamic-pituitary-adrenal axis function. We report the case of a boy with asthmatic symptoms and a late diagnosis of celiac disease, in whom inhaled budesonide in a dose used in conventional asthma therapy seems to have been systemically absorbed in amounts large enough to temporarily disguise the symptoms of a developing adrenal insufficiency. Inhaled corticosteroids in a dose used in standard asthma therapy seem to have the potential of disguising a developing Addison's disease. Furthermore, celiac disease, especially if diagnosed in late childhood, may be associated with Addison's disease causing a complex symptom pattern.
authors.affiliation: Department of Pediatrics, Linköping University, Norrköping Hospital, Norrköping, Sweden.
authors.forename: Lars C
authors.initials: LC
authors.lastname: Stenhammar
authors.forename: Lotta M
authors.initials: LM
authors.lastname: Högberg
authors.forename: Maria
authors.initials: M
authors.lastname: Nordwall
authors.forename: Leif G E
authors.initials: LG
authors.lastname: Strömberg
keywords: Addison's disease; celiac disease; inhaled corticosteroids