title: An unusual cause of growth failure in cystic fibrosis: A salutary reminder of the interaction between glucocorticoids and cytochrome P450 inhibiting medication.
abstract: A 12 ½ year old male with cystic fibrosis presented with growth failure after itraconazole was added to a treatment regimen including inhaled and intranasal glucocorticoids. Investigations showed severe adrenal suppression. This case demonstrates the potential for exogenous glucocorticoids to accumulate when their degradation is inhibited by a CYP3A4 inhibitor.
authors.affiliation: Liggins Institute, University of Auckland, Auckland, New Zealand.
authors.forename: Benjamin B
authors.initials: BB
authors.lastname: Albert
authors.affiliation: Starship Children's Health, Auckland District Health Board, Auckland, New Zealand; Department of Paediatrics, University of Auckland, New Zealand.
authors.forename: Mirjana
authors.initials: M
authors.lastname: Jaksic
authors.affiliation: University of California, Los Angeles, United States.
authors.forename: Jessica
authors.initials: J
authors.lastname: Ramirez
authors.affiliation: University of California, Los Angeles, United States.
authors.forename: Jacqueline
authors.initials: J
authors.lastname: Bors
authors.affiliation: Starship Children's Health, Auckland District Health Board, Auckland, New Zealand.
authors.forename: Philippa
authors.initials: P
authors.lastname: Carter
authors.affiliation: Liggins Institute, University of Auckland, Auckland, New Zealand.
authors.forename: Wayne S
authors.initials: WS
authors.lastname: Cutfield
authors.affiliation: Liggins Institute, University of Auckland, Auckland, New Zealand. Electronic address: p.hofman@auckland.ac.nz.
authors.forename: Paul L
authors.initials: PL
authors.lastname: Hofman
mesh_terms: D002648:Child; D003550:Cystic Fibrosis / Q000188:drug therapy*; D065692:Cytochrome P-450 CYP3A Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D004347:Drug Interactions; D005938:Glucocorticoids / Q000008:administration & dosage / Q000009:adverse effects*; D006130:Growth Disorders / Q000209:etiology*; D006801:Humans; D017964:Itraconazole / Q000008:administration & dosage / Q000009:adverse effects*; D008297:Male
chemical_list: D065692:Cytochrome P-450 CYP3A Inhibitors; D005938:Glucocorticoids; D017964:Itraconazole
keywords: Adrenal suppression; Cystic fibrosis; Glucocorticoid; Growth failure; Itraconazole