Función Suprarrenal en Pacientes con Síndrome Bronquial Obstructivo Tratados con Corticoides Sistémicos (Informe Preliminar)

Abstract

Adrenal Function in Patients with Acute Bronchial Obstruction Treated with Systemic Corticosteroids: A Preliminary Report Introduction: Systemic corticosteroids are widely used in patients with acute bronchial obstruction (ABO). It has been recommended that such treatment last a maximum of 5 days to avoid adverse effects. Suppression of the adrenal axis under these conditions among children has not been evaluated. Objective: Assessment of the hypothalamic pituitary adrenal axis (HHS) function after use of systemic steriods in children after a 5-7 day use of corticoids, utilizing the micro ACTH test. Method: Prospective observational study conducted in the Department of Pediatrics, Hospital Clínico Universidad Católica de Chile. ACTH test used with microdosis (1 mcg/1.73 m 2). A normal response was determined if cortisol post-ACTH > 20 mcg/dL. Results: 7 patients were recruited, median age was 4 years 4 months (range 4 months to 8 years). The test was perfomed within an average of 72 hours after discontinuation of prednisone. All patients had normal basal cortisol values, with an average value of 6.5 mcg/dl, range 1 to 9 mcg/dl. The ACTH test yielded a response of cortisol levels with an average value of 13.6 mcg/dL and a range of 3.7 to 20 mcg/dL. Five of the 7 patients presented an abnormal response. Conclusions: Our results suggest that the adrenal response may be reduced in children who have been treated with systemic steroids for ABO even if managed during short periods of time.

Caracterización de reacciones adversas a medicamentos (RAMs) en pacientes pediátricos en tratamiento con corticoides sistémicos entre enero y diciembre de 2019: Un reporte preliminar

“…Se ha observado también la supresión del eje hipotálamopituitaria-adrenal en un porcentaje de hasta 81% de niños que recibieron corticoides sistémicos, incluso con dosis habituales de prednisona por períodos tan breves como 5 días, afortunadamente, sin repercusiones graves y con normalización de los parámetros fisiológicos al cabo de 10-12 días desde la suspensión del corticoide administrado (12,13). En Chile, fue descrita una experiencia similar de supresión del eje adrenal posterior a la administración de corticoides secundario a crisis bronquiales, la cual fue transitoria (14). No se encontraron otros estudios o reportes nacionales respecto a la prevalencia de efectos adversos asociados a corticoides por períodos cortos.…”