Hypothalamic-pituitary-adrenal axis suppression in asthmatic children on inhaled and nasal corticosteroids - More common than expected?

Journal of Pediatric Endocrinology and Metabolism

Volumn 24, Issue 7-8, 2011, Pages 529-534

  Zöllner, Ekkehard Werner ^a   Lombard, Carl ^b   Galal, Ushma ^b   Hough, Stephen ^a   Irusen, Elvis ^a   Weinberg, Eugene ^c  

^a STELLENBOSCH UNIVERSITY   (South Africa)

^b SOUTH AFRICAN MEDICAL RESEARCH COUNCIL   (South Africa)

^c UNIVERSITY OF CAPE TOWN   (South Africa)

Author keywords

adrenal insufficiency; asthma; pituitary adrenal function tests; steroids adverse effects

Indexed keywords

BECLOMETASONE; BUDESONIDE; CORTICOSTEROID; CORTICOTROPIN; METYRAPONE;

ADULT; ARTICLE; ASTHMA; CHILD; CLINICAL ARTICLE; CLINICAL FEATURE; ENDOCRINE DISEASE; HUMAN; HYPOTHALAMUS HYPOPHYSIS ADRENAL SYSTEM; HYPOTHALAMUS HYPOPHYSIS ADRENAL SYSTEM SUPPRESSION; PRESCHOOL CHILD; PREVALENCE; SCHOOL CHILD;

ADMINISTRATION, INHALATION; ADMINISTRATION, INTRANASAL; ADOLESCENT; ADRENAL CORTEX HORMONES; ADRENAL INSUFFICIENCY; ADRENOCORTICOTROPIC HORMONE; ASTHMA; BUDESONIDE; CHILD; CHILD, PRESCHOOL; ENZYME INHIBITORS; FEMALE; HUMANS; HYDROCORTISONE; HYPOTHALAMO-HYPOPHYSEAL SYSTEM; MALE; METYRAPONE; PITUITARY-ADRENAL SYSTEM; PREVALENCE; RISK FACTORS; STEROID 11-BETA-HYDROXYLASE; TURKEY;

EID: 80051989922     PISSN: 0334018X     EISSN: 21910251     Source Type: Journal    
DOI: 10.1515/JPEM.2011.198     Document Type: Article

References (29)

1. Ehrlich RI, Du Toit D, Jordaan E, Volmink JA, Weinberg EG, et al. Prevalence and reliability of asthma symptoms in primary school children in Cape Town. Int J Epidemiol 1995;24:1138-46.
2. Perera BJ. Effi cacy and cost effectiveness of inhaled steroids in asthma in a developing country. Arch Dis Child 1995;72:312-6.
3. Calpin C, Macarthur C, Stephens D, Feldman W, Parkin PC. Effectiveness of prophylactic inhaled steroids in childhood asthma: A systematic review of the literature. J Allergy Clin Immunol 1997;100:452-7.
4. Price J. The role of inhaled corticosteroids in children with asthma. Arch Dis Child 2000;82f(Suppl II):ii10-4.
5. Bisgaard H. Use of inhaled corticosteroids in pediatric asthma. Pediatr Pulmonol 1997;(Suppl 15):27-33.
6. Wagener JS. Inhaled steroids in children: Risks versus rewards. J Pediatr 1998;132:381-3.
7. Lipworth BJ. Adrenal suppression with inhaled corticosteroids. Ann Allergy Asthma Immunol 2001;87:359-61.
8. Dluhy RG. Clinical relevance of inhaled corticosteroids and HPA axis suppression. J Allergy Clin Immunol 1998;101:S447-50.
9. Russel G. Commentary: Symptomatic adrenal insuffi ciency during inhaled corticosteroid treatment. Arch Dis Child 2001;85:333-4.
10. Bisgaard H, Pedersen S. Safety of treatment. Eur Respir J 1996;(Suppl 21):28s-34s.
11. Sizonenko P. Effects of inhaled or nasal glucocortioids on adrenal function and growth. J Pediat Endocrinol Metab 2002;15:5-26.
12. Boner AL. Effects of intranasal corticosteroids on the hypothalamic- pituitary-adrenal axis in children. J Allergy Clin Immunol 2001;108:S32-9.
13. Bruni FM, De Luca G, Venturoli V, Boner AL. Intranasal corticosteroids and adrenal suppression. Neuroimmunomodulation 2009;16:353-62.
14. Law CM, Marchant JL, Honour JW, Preece MA, Warner JO. Nocturnal adrenal suppression in asthmatic children taking inhaled beclomethasone diproprionate. Lancet 1986;1:942-4.
15. Tabachnik E, Zadik Z. Diurnal cortisol secretion during therapy with inhaled beclomethasone dipropionate in children with asthma. J Pediatr 1991;118:294-7.
16. Phillip M, Aviram M, Leiberman E, Zadik Z, Giat Y, et al. Integrated plasma cortisol concentration in children with asthma receiving long-term inhaled corticosteroids. Pediatr Pulmonol 1992;12:84-9.
17. Zöllner EW. Hypothalamic-piuitary-adrenal axis suppression in asthmatic children on inhaled corticosteroids: Part 1. Which test should be used ? Pediatr Allergy Immunol 2007;18:401-9.
18. Cochrane MG, Bala MV, Downs KE, Mauskopf J, Ben-Joseph RH. Inhaled corticosteroids for asthma therapy. Patient compliance, devices, and inhalation technique. Chest 2000;117: 542-50.
19. Staub JJ, Noelpp B, Girard J, Baumann JB, Graf S, et al. The short metyrapone test: Comparison of the plasma ACTH response to metyrapone and insulin-induced hypoglycaemia. Clin Endocrinol 1979;10:595-601.
20. Z ö llner EW. Hypothalamic-pituitary-adrenal axis suppression in asthmatic children on inhaled corticosteroids (Part 2)-the risk as determined by gold standard adrenal function tests: A systematic review. Pediatr Allergy Immunol 2007;18:469-74.
21. Motala C, Green RJ, Manjra AJ, Potter PC, Zar HJ. Guideline for the management of chronic asthma in children-2009 update. S Afr Med J 2009;99:898-912.
22. Cochrane GM. Compliance and outcomes in patients with asthma. Drugs 1996;52(Suppl 6):12-9.
23. Spitzer SA, Kaufman H, Koplovitz A, Topilsky M, Blum I. Beclomethasone dipropionate and chronic asthma. The effect of long-term aerosol administration on the hypothalamic-pituitaryadrenal axis after substitution for oral therapy with corticosteroids. Chest 1976;70:38-42.
24. National Asthma Education and Prevention Program. Expert Panel Report 3: Guidelines for the Diagnosis and Management of Asthma. Full Report 2007. US National Heart, Lung and Blood Institute. Available at: Http://www.nhlbi.nih. gov/guidelines/ asthma/asthgdln.pdf.
25. Graber AL, Ney RL, Nicholson WE, Island DP, Liddle GW. Natural history of pituitary-adrenal recovery following long-term suppression with corticosteroids. J Clin Endocrinol 1965;25: 11-6.
26. Dolman LI, Nolan G, Jubiz W. Metyrapone test with adrenocorticotrophic levels. Separating primary from secondary adrenal insuffi ciency. J Am Med Assoc 1979;241:1251-3.
27. Corrigan CJ, Loke T-K. Clinical and molecular aspects of glucocorticoid resistant asthma. Ther Clin Risk Manage 2007;3:771-87.
28. Crowley S. Inhaled glucocorticoids and adrenal function: An update. Paediatr Respir Rev 2003;4:153-61.
29. Doull IJ. The effect of asthma and its treatment on growth. Arch Dis Child 2004;89:60-3.