Adrenocortical function in children on high-dose steroid aerosol therapy. Results of serum cortisol, ACTH stimulation test and 24 hour urinary free cortical excretion

Allergy. 1987 Oct;42(7):541-4. doi: 10.1111/j.1398-9995.1987.tb00379.x.

Abstract

The adrenocortical function was investigated in 18 children treated with high-doses of inhaled glucocorticoid aerosol (mean: 1965 micrograms/1.73 m2 body surface a day). Basal serum cortisol was only below the normal range in patients treated with doses exceeding 2500 micrograms/1.73 m2 body surface. 15 of 18 children had normal 24 h urinary free cortisol excretion, compared with 27 normal children matched for age, sex and body surface. Three patients taking more than 2400 micrograms/1.73 m2 body surface showed excretion values below the range for the normal controls. 10 of 12 patients showed a normal response to a short ACTH stimulation test. One patient treated with 3300 micrograms/1.73 m2 body surface showed no response and one patient gave a borderline response to ACTH. We concluded that doses up to 2000 micrograms/1.73 m2 body surface/24 can be administered by pressurized aerosol with little risk of adrenocortical suppression.

MeSH terms

  • Administration, Inhalation
  • Adolescent
  • Adrenal Cortex / physiopathology*
  • Asthma / drug therapy*
  • Asthma / physiopathology
  • Beclomethasone / administration & dosage
  • Budesonide
  • Child
  • Cosyntropin
  • Female
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use*
  • Humans
  • Hydrocortisone / blood
  • Hydrocortisone / urine
  • Male
  • Pregnenediones / administration & dosage

Substances

  • Glucocorticoids
  • Pregnenediones
  • Cosyntropin
  • Budesonide
  • Beclomethasone
  • Hydrocortisone