Abstract
We report a perinatally HIV infected adolescent on a protease-inhibitor containing antiretroviral regimen who developed iatrogenic Cushing's syndrome while receiving intensive ophthalmic corticosteroid therapy for granulomatous panuveitis. Although pharmacokinetic drug interactions between protease inhibitors and oral/inhaled corticosteroids have previously been described, this is the first report involving ophthalmic administration of corticosteroids and lopinavir/ritonavir in an adolescent.
Highlights
There are many drug interactions between antiretroviral agents and other medications, often complicating the management of HIVinfected patients with co-morbidities
We report a case of an HIV-infected adolescent female who developed iatrogenic Cushing’s syndrome and adrenal insufficiency due to pharmacokinetic interaction of intra-ocular corticosteroids and lopinavir-ritonavir
In volunteers administered hourly dexamethasone 0.1% drops for 6 days, a 50% decrease was observed in endogenous cortisol production [1]
Summary
Iatrogenic Cushing's Syndrome Due to Pharmacokinetic Interaction of Intra-Ocular Corticosteroids and Lopinavir/Ritonavir in an HIV-Infected Adolescent: A Case Report. Diana F Clarke*, Carole Moloney and Ellen R Cooper Boston Medical Center, Section of Pediatric Infectious Diseases, Boston, USA
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