Abstract
Adrenal Suppression and Exogenous Cushing Syndrome After Inhaled and Topical Corticosteroids - Two Clinical Cases and Review of the Subject
Highlights
Efectele endocrine nedorite asociate terapiei farmacologice cu corticosteroizi administraţi oral sau parenteral sunt bine cunoscute în practica medicală
The possibility of exogenous Cushing syndrome after treatments with topical corticosteroids was emphasized in earlier syntheses
Morning 8- 9AM serum cortisol* - A baseline cortisol result below 100 nmol/l is considered highly indicative of adrenal insufficiency
Summary
Corticosteroid (CS) therapy is used by 1% of world population, especially for non-endocrinological indications. Compartmental administration of CS (i.e. topical, inhaled or intraarticular) was developed to prevent undesired effects Still even these therapies could generate major endocrine syndromes, as our two cases tend to illustrate – Table 1 and Table 2. Adrenal Suppression and Exogenous Cushing Syndrome After Inhaled and Topical Corticosteroids a Two years before referral – tests suggestive of adrenal suppression preceding the assumed adrenal crisis during the sepsis. According to the pharmaceutical route of administration glucocorticoid (GC) therapy can be divided in: (a) systemic: oral, intravenous, intramuscular, and subcutaneous; (b) local or compartmental: topic (cutaneous, nasal, ophthalmic); inhaled; intraarticular. Super-active agents such as clobetasol ointment 0.05% can produce HPA suppression at doses as low as 2g/ day and can result in Cushing syndrome at doses larger than 50 g/week
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