Table 1—

Clinical features of three patients with chronic lung disease with adrenal suppression attributed to prolonged inhaled corticosteroid therapy

Case	Sex	Age yrs	Diagnosis	Daily maintenance treatment	Extra steroid treatment	Symptoms and signs	Basal cortisol nmol·L⁻¹	Post- Synacthen cortisol nmol·L⁻¹
1	Female	27	Bronchiectasis Asthma	1 mg fluticasone	2–3 short courses oral prednisolone per yr	Fatigue, lethargy, malaise, depression, nausea, vomiting, hypotension especially with exacerbation	<20	32
2	Female	63	COPD Bronchiectasis	1 mg fluticasone	2 short courses prednisolone per yr	Fatigue, falls, postural hypotension	80	253
					Occasional nasal steroid
3	Female	81	Bronchiectasis	1 mg fluticasone	4–5 short courses prednisolone per yr	Arthralgia, malaise, fatigue	175	397