Inhalationssteroider kan ge sekundär binjurebarkssvikt. Även vuxna astmatiker kan drabbas - inte bara barn
Engelsk titel: Inhaled steroids may cause secondary adrenocortical deficiency. Adult asthmatics can also be affected - not just children
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Författare:
Karlsson, Carl-Axel
;
Isaksson, Magnus
;
Janson, Christer
Email: karl.axel.karlsson@akademiska.se
Språk: Swe
Antal referenser: 24
Dokumenttyp:
Fallbeskrivning
UI-nummer: 14047850
Sammanfattning
Inhaled steroids have for several decades been a cornerstone of asthma treatment. They have a reputation of being well tolerated and having few side effects. It is common knowledge that long-time systemic steroid treatment is accompanied by a multitude of side-effects. One of them is the effect on the hypothalamic-pituitary-adrenal axis with more or less decreased function of the adrenal cortex. In the literature there are some case reports of adrenal insufficiency secondary to treatment with inhaled steroids, mostly among children. We report three cases of secondary adrenal insufficiency in adult asthmatics treated with fluticasone propionate with doses slightly above the recommended limit. Our conclusion is that significant adrenal side effects of inhaled steroids seem to be more common than previously thought. The recommendation is to measure cortisol in serum (in the morning) or make a Synacthen test in patients that could be at risk of adrenal dysfunction.