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Cushing's syndrome from an inhaled glucocorticoid
Author(s) -
Chalkley Simon M,
Chisholm Donald J
Publication year - 1994
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1994.tb125866.x
Subject(s) - medicine , budesonide , glucocorticoid , androgen , asthma , anesthesia , osteoporosis , inhalation , hormone
Objective To report a case of significant systemic side effects from an inhaled glucocorticoid at a reported dose in the upper recommended therapeutic range. Clinical features A 25‐year‐old white man with asthma treated with inhaled glucocorticoid (beclomethasone 1500 |ig daily), and primary testicular failure with inadequate androgen replacement, was referred with back pain. He was found to have osteoporosis, clinical features of Cushing's syndrome and complete suppression of endogenous adrenocortico‐trophic hormone adrenal function. Intervention and outcome He was recommended to receive adequate androgen replacement and to use a spacer device with the inhaled beclomethasone, or to change to budesonide via a Turbuhaler (AB Astra, Sweden). Conclusions Inhaled glucocorticoids should not be regarded as entirely safe, as serious systemic side effects may occur at doses at the upper level of the recommended therapeutic range.