RT Journal Article
SR Electronic
T1 Acute adrenal crisis in asthmatics treated with high-dose fluticasone propionate
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 1207
OP 1209
DO 10.1183/09031936.02.00274402
VO 19
IS 6
A1 G.R.G. Todd
A1 C.L. Acerini
A1 J.J. Buck
A1 N.P. Murphy
A1 R. Ross-Russell
A1 J.T. Warner
A1 D.R. McCance
YR 2002
UL http://erj.ersjournals.com/content/19/6/1207.abstract
AB Four cases of asthma (one adult, three children) developing acute adrenal crisis after introduction of high-dose inhaled fluticasone proprionate are presented. The three children, aged 7–9 yrs, had been prescribed inhaled fluticasone, dosage 500–2,000 µg·day−1 and duration 5 months–5 yrs. All presented with convulsions due to hypoglycaemia (blood glucose 1.3–1.8 mM). The fourth case was a male of 33 yrs with difficult-to-control asthma and had been taking fluticasone propionate 1,000–2,000 µg·day−1 for 3 yrs. He presented with fatigue, lethargy, nausea and postural hypotension. Acute adrenal crisis in each case was confirmed by investigations which included measurement of acute phase cortisol levels, short and long Synacthen stimulation tests and glucagon stimulation tests. Other cases of hypthoalamic-pituitary-adrenal axis suppression were excluded.