Asthma and Cushing's syndrome

Chest. 2000 Feb;117(2):593-4. doi: 10.1378/chest.117.2.593.

Abstract

A female patient was treated with high-dose inhaled fluticasone propionate for her asthma. Over 2 years, she developed features of Cushing's syndrome with proximal myopathy, osteopenia, hypertension, depressive psychosis, and cushingoid appearance. She had biochemical evidence of marked adrenal suppression with a 9:00 AM serum cortisol of 20 nmol/L that returned to normal (315 mol/L) after her therapy was changed to budenoside, 0.8 mg/d. Her appearance, mental state, and myopathy also improved with no loss of asthma control. This case illustrates the potential for developing clinically relevant adverse effects of inhaled corticosteroids when given at licensed doses.

Publication types

  • Case Reports

MeSH terms

  • Administration, Inhalation
  • Androstadienes / administration & dosage
  • Androstadienes / adverse effects*
  • Anti-Asthmatic Agents / administration & dosage
  • Anti-Asthmatic Agents / adverse effects*
  • Anti-Inflammatory Agents / administration & dosage
  • Anti-Inflammatory Agents / adverse effects*
  • Asthma / drug therapy*
  • Budesonide / administration & dosage
  • Cushing Syndrome / chemically induced*
  • Cushing Syndrome / diagnosis
  • Dose-Response Relationship, Drug
  • Female
  • Fluticasone
  • Humans
  • Hydrocortisone / blood
  • Middle Aged

Substances

  • Androstadienes
  • Anti-Asthmatic Agents
  • Anti-Inflammatory Agents
  • Budesonide
  • Fluticasone
  • Hydrocortisone