title: Iatrogenic Cushing's syndrome related to the interaction between oral budesonide with fluvoxamine: a case report.
abstract: OBJECTIVE
  Budesonide, an oral glucocorticoid indicated for the treatment of Crohn's disease, rarely interferes with the hypothalamic-pituitary-adrenal axis because more than 80% of it is metabolized by cytochrome P450 enzymes.
  
  
  METHODS
  A 33-year-old female patient diagnosed with Crohn's disease, treated with oral budesonide, was admitted for Cushingoid symptoms and signs. The onset coincided with the use of fluvoxamine, a serotonin reuptake inhibitor and also a potent inhibitor of cytochrome P450 enzymes that presumably led to budesonide accumulation.
  
  
  CONCLUSIONS
  Practitioners should take into consideration the possibility of iatrogenic Cushing's syndrome caused by the association of oral budesonide with a P450 cytochrome inhibitor.
authors.affiliation: Endocrinology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.|Endocrinology Department, Elias Hospital, Bucharest, Romania.
authors.forename: C S
authors.initials: CS
authors.lastname: Martin
authors.affiliation: Endocrinology Department, Elias Hospital, Bucharest, Romania.
authors.forename: C
authors.initials: C
authors.lastname: Blaga
authors.affiliation: Endocrinology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
authors.forename: I M
authors.initials: IM
authors.lastname: Lambrescu
authors.affiliation: Gastroenterology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.|Medical Clinic II and Gastroenterology, Universitary Hospital Bucharest, Bucharest, Romania.
authors.forename: C
authors.initials: C
authors.lastname: Fierbințeanu-Braticevici
authors.affiliation: Endocrinology Department, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.|Endocrinology Department, Elias Hospital, Bucharest, Romania.
authors.forename: S
authors.initials: S
authors.lastname: Fica
keywords: CYP3A4; Crohn's disease; Cushing's syndrome; budesonide; fluvoxamine