title: Iatrogenic Cushing's syndrome in children following nasal steroid.
abstract: Cushing syndrome is a hormonal disorder caused by prolonged exposure of body tissue to cortisol. We report two cases of iatrogenic Cushing's syndrome in two Nigerian children following intranasal administration of aristobed-N (Betamethasone + Neomycin) given at a private hospital where the children presented with feature of adenoidal hypertrophy. Two months into treatment children were noticed to have developed clinical and laboratory features of iatrogenic Cushing's syndrome with critical adrenal suppression. Serum cortisol (at presentation): 1(st) patient: 12nmol/L (reference range 240-618), 2(nd)
  
  
  METHODS
  1.69nmol/L. Serum cortisol (3 months after weaning off steroid): 343.27 nmol/L (within normal range for the first patient; second patient newly presented and has just begun steroid weaning off process. The serum cortisol level one month into weaninig off process was 128 nmol/L). Unsupervised topical steroid administration in children can cause adrenal suppression with clinical features of Cushing's syndrome.
authors.affiliation: Paediatric Endocrinology Training Centre for West Africa, Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria.
authors.forename: Isaac Oludare
authors.initials: IO
authors.lastname: Oluwayemi
authors.affiliation: Paediatric Endocrinology Training Centre for West Africa, Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria.
authors.forename: Abiola Olufunmilayo
authors.initials: AO
authors.lastname: Oduwole
authors.affiliation: Paediatric Endocrinology Training Centre for West Africa, Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Oyenusi
authors.affiliation: Paediatric Endocrinology Training Centre for West Africa, Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria.
authors.forename: Alphonsus Ndidi
authors.initials: AN
authors.lastname: Onyiriuka
authors.affiliation: Paediatric Endocrinology Training Centre for West Africa, Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria.
authors.forename: Muhammad
authors.initials: M
authors.lastname: Abdullahi
authors.affiliation: Paediatric Endocrinology Training Centre for West Africa, Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria.
authors.forename: Olubunmi Benedicta
authors.initials: OB
authors.lastname: Fakeye-Udeogu
authors.affiliation: Paediatric Endocrinology Training Centre for West Africa, Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria.
authors.forename: Chidozie Jude
authors.initials: CJ
authors.lastname: Achonwa
authors.affiliation: Paediatric Endocrinology Training Centre for West Africa, Lagos University Teaching Hospital, Idi-araba, Lagos, Nigeria.
authors.forename: Moustapha
authors.initials: M
authors.lastname: Kouyate
mesh_terms: D000281:Administration, Intranasal; D001623:Betamethasone / Q000008:administration & dosage / Q000009:adverse effects*; D003480:Cushing Syndrome / Q000139:chemically induced*; D004338:Drug Combinations; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007049:Iatrogenic Disease; D007223:Infant; D008297:Male; D009355:Neomycin / Q000008:administration & dosage / Q000009:adverse effects*; D009549:Nigeria
chemical_list: D004338:Drug Combinations; D005938:Glucocorticoids; C081596:betamethasone, neomycin drug combination; D001623:Betamethasone; D009355:Neomycin; D006854:Hydrocortisone
keywords: Iatrogenic; cushing's syndrome; nasal steroid