Adrenal suppression from high-dose inhaled fluticasone propionate in children with asthma: Fig. 1.—

Sim, Derrick; Griffiths, Amanda; Armstrong, David; Clarke, Cathriona; Rodda, Christine; Freezer, Nicholas

doi:10.1183/09031936.03.00306302

Cited by 65 publications

(39 citation statements)

References 35 publications

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“…The data from the current study of adrenal suppression in 20.8% of asthmatic children on mild and moderate doses of budesonide are in general agreement with the literature. The present authors do not know whether these children would present symptomatic adrenal insufficiency if they were treated with much larger doses of budesonide, such as children on large doses of fluticasone who reportedly experienced adrenal crisis [7][8][9][25][26][27]]. …”

Section: Discussionmentioning

confidence: 99%

The effect of inhaled budesonide on adrenal and growth suppression in asthmatic children

Priftis

Papadimitriou²,

Gatsopoulou³

et al. 2006

Eur Respir J

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The present authors evaluated adrenal reserve in asthmatic children on long-term inhaled corticosteroids and whether possible adrenal suppression could be predicted by growth retardation.Low-dose synacthen test (0. . The current authors calculated height standard deviation score (HSDS) at the time of testing and height velocity SDS (HVSDS) in the preceding year.Mean HSDS was 0.06¡1.3 and HVSDS was -0.9¡2.3. Adrenal suppression was disclosed in 15 asthmatic children (20.8%). There were no differences in HSDS and HVSDS between children with and without adrenal suppression. There was no correlation between peak cortisol response and dose or duration of treatment. However, a positive relationship between HVSDS and duration of treatment was noted.These data suggest that long-term treatment of asthmatic children with low and moderate doses of inhaled budesonide may result in mild adrenal suppression that cannot be predicted by growth deceleration. The negative influence of inhaled corticosteroids on growth becomes less the longer the duration of treatment.

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Section: Discussionmentioning

confidence: 99%

The effect of inhaled budesonide on adrenal and growth suppression in asthmatic children

Priftis

Papadimitriou²,

Gatsopoulou³

et al. 2006

Eur Respir J

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“…However, the presence of airway eosinophilia potentially provides evidence that can help to optimise the dose and improve the delivery of inhaled steroids. This is important as inappropriately high-dose inhaled steroids may have significant side-effects, including severe hypoglycaemia [27], along with possible adverse effects on alveolar development [28].…”

Section: Investigations In Preschool Wheezers S Saglani Et Almentioning

confidence: 99%

Investigation of young children with severe recurrent wheeze: any clinical benefit?

Saglani

Nicholson²,

Scallan³

et al. 2006

Eur Respir J

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The management of young children with severe recurrent wheeze is difficult because symptoms are often refractory to conventional asthma therapy and other diagnoses must be excluded. The present authors aimed to evaluate the outcome of detailed, invasive investigations in such patients.Children aged between 3 months and 5 yrs with severe recurrent wheezing, who had been referred to a tertiary centre, underwent a protocol of investigations including a chest computed tomography scan, blood tests, nasal ciliary brushings, fibreoptic bronchoscopy, bronchoalveolar lavage (BAL), endobronchial biopsy and passage of an oesophageal pH probe.A total of 47 children (25 males) with a median age of 26 (range 5-58) months underwent investigation. Of these, 39% were atopic, two-thirds had evidence of gastro-oesophageal reflux and 37 out of 47 had an abnormal bronchoscopy. Findings included structural abnormalities (13 out of 37), excessive mucus (20 out of 37) and macroscopic inflammation (10 out of 37). BAL revealed bacterial growth in 12 out of 44 (27%) patients. Good quality endobronchial biopsies were obtained from 36 out of 46 (78%) patients; of these, 44% had tissue eosinophila and 28% had a thickened reticular basement membrane.Additional investigations (including bronchoscopy) in young children with severe wheeze may help to identify positive diagnoses and provide information to support a clinical diagnosis of asthma. This hypothesis-generating work should form the basis of future interventional studies.

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“…The effects of ICS depend on the type of the drug, the dose, and the amount of drug that is absorbed [9]. A study by Sim et al, 2003, suggested that high-dose ICS can induce adrenal suppression in children with BA [45]. In 2004 Mohn et al, published a research, suggestng that also low dose ICS treatments are associated with the adrenal axis suppression [30].…”

Section: Resultsmentioning

confidence: 99%

Review of different anthropometric and nutritional measurements in children with bronchial asthma

Lipsberga

Kažoka

2015

PoA

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The aims of this study were to describe and compare the recent literature data of anthropometric and nutritional measurements in children with bronchial asthma from the researches published in the last 10 years. 46 studies from the year 2003 to 2014 were reviewed and analyzed along with the information published before. The measurements reviewed include body height, body weight, body mass index and body composition.The severity and duration of bronchial asthma, along with the inhaled corticosteroid treatment, negatively correlate with the height of the children. Also, the fat free mass of the body is decreased and fat mass is increased. Due to more robust body build and the body mass index in children with bronchial asthma is usually increased if compared to healthy children. An increased body mass index in these children reduces the effectiveness of the treatment. Increased body mass index can also be a predictor for the risk for developing late onset bronchial asthma in girls.

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Adrenal suppression from high-dose inhaled fluticasone propionate in children with asthma: Fig. 1.—

Cited by 65 publications

References 35 publications

The effect of inhaled budesonide on adrenal and growth suppression in asthmatic children

The effect of inhaled budesonide on adrenal and growth suppression in asthmatic children

Investigation of young children with severe recurrent wheeze: any clinical benefit?

Review of different anthropometric and nutritional measurements in children with bronchial asthma

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