Abstract
Intranasal steroids are widely used to treat olfactory disorder, and are known to have fewer side effects than systemic steroids. However, there are some reports that intranasal steroids have induced adrenal insufficiency, even when the steroid dosage is appropriate. We encountered a case of secondary adrenal insufficiency after using intranasal betamethasone for olfactory disorder within the usual dosage. In this case, we were not aware of instructing the patient not to swallow the steroid which had dripped into her pharynx. Thus, a large amount of steroids which had passed through her nasal cavity might have been absorbed in the oropharyngeal mucosa and also ingested. That is possibly the main cause of developing adrenal insufficiency. Recently, Toki-shakuyaku-san, a traditional Chinese medicine, has started to be used for olfactory disorder after a cold. Because of its minimum side effects, it may be safely used for patients with the risk associated with steroid use.
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