title: Adrenal Suppression in Children Treated With Oral Viscous Budesonide for Eosinophilic Esophagitis.
abstract: We sought to determine the prevalence of adrenal suppression (AS) in children with eosinophilic esophagitis treated with oral viscous budesonide (OVB). This was a retrospective review of a quality assurance initiative, whereby all children in our center treated with OVB for ≥3 months were referred over an 18-month time frame for endocrine assessment including 1 μg adrenocorticotropic hormone stimulation test. Fourteen of 19 children complied with the referral; of these 14 children, 6 (43%) had suboptimal stimulated cortisol (range 343-497 nmol/L, mean [±SD] 424.7 nmol/L [±52.4], normal ≥500 nmol/L). There was no significant association to treatment duration, dose, or concomitant use of inhaled/nasal corticosteroids. This study suggests that children treated with OVB may be at risk for AS.
authors.affiliation: *Endocrinology and Diabetes Unit †Division of Allergy and Immunology, Department of Pediatrics ‡Division of Pediatric Gastroenterology, Hepatology and Nutrition, British Columbia Children's Hospital, University of British Columbia, Vancouver, BC.
authors.forename: Shira
authors.initials: S
authors.lastname: Harel
authors.forename: Brenden E
authors.initials: BE
authors.lastname: Hursh
authors.forename: Edmond S
authors.initials: ES
authors.lastname: Chan
authors.forename: Vishal
authors.initials: V
authors.lastname: Avinashi
authors.forename: Constadina
authors.initials: C
authors.lastname: Panagiotopoulos
mesh_terms: D000293:Adolescent; D000309:Adrenal Insufficiency / Q000139:chemically induced / Q000175:diagnosis / Q000453:epidemiology*; D000324:Adrenocorticotropic Hormone / Q000008:administration & dosage; D001249:Asthma / Q000150:complications; D019819:Budesonide / Q000008:administration & dosage / Q000009:adverse effects* / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D057765:Eosinophilic Esophagitis / Q000188:drug therapy*; D005260:Female; D005938:Glucocorticoids / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D006854:Hydrocortisone / Q000097:blood; D008297:Male; D012189:Retrospective Studies
chemical_list: D005938:Glucocorticoids; D019819:Budesonide; D000324:Adrenocorticotropic Hormone; D006854:Hydrocortisone