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Type:	Artigo de Periódico
Title:	Oral corticosteroids for asthma exacerbations might be associated with adrenal suppression: Are physicians aware of that?
Authors:	Cristina Botelho Barra Maria Jussara Fernandes Fontes Marco Túlio Gualberto Cintra Janaina Andrade Guimarães M.c.c. Guimarães Renata Campos da Cruz Ivani Novato Silva
Abstract:	Introduction: Oral corticosteroids (OCS) are a mainstay of treatment for asthma exacerbations, and short-term OCS courses were generally considered to be safe.Nevertheless, frequent short-term OCS courses could lead to hypothalamicpituitary-adrenal (HPA) axis dysfunction. Our study aimed at investigating the integrity of the HPA axis in children with persistent asthma or recurrent wheezing at the beginning of an inhaled corticosteroids (ICS) trial. Method: Morning basal cortisol was assessed just before the beginning of ICS, and 30, 60, and 90 days later, using Immulite® Siemens Medical Solutions.Diagnostic chemiluminescent enzyme immunoassay (Los Angeles, USA; 2006).Results: In all, 140 children (0.3-15 years old) with persistent asthma or recurrent wheezing have been evaluated and 40% of them reported short-term OCS courses for up to 30 days before evaluation. Out of these, 12.5% had biochemical adrenal suppression but showed adrenal recovery during a three-month ICS trial treatment. No significant differences were observed among children with or without adrenal suppression, neither in the number of days free of OCS treatment before cortisol evaluation (p=0.29) nor in the last OCS course duration (p=0.20). The number of short-term OCS courses reported in the year preceding the cortisol evaluation was also not different (p=0.89). Conclusion: Short-term systemic courses of corticosteroids at conventional doses can put children at risk of HPA axis dysfunction. ICS treatment does not impair adrenal recovery from occurring. Health practitioners should be aware of the risk of a blunted cortisol response upon exposure to stress during the follow-up of patients with persistent asthma or recurrent wheezing.
Subject:	Asma Corticosteroides Supressão Criança
language:	eng
metadata.dc.publisher.country:	Brasil
Publisher:	Universidade Federal de Minas Gerais
Publisher Initials:	UFMG
metadata.dc.publisher.department:	MED - DEPARTAMENTO DE CLÍNICA MÉDICA MED - DEPARTAMENTO DE PEDIATRIA
Rights:	Acesso Aberto
metadata.dc.identifier.doi:	https://doi.org/10.1590/1806-9282.63.10.899
URI:	http://hdl.handle.net/1843/57565
Issue Date:	2-May-2017
metadata.dc.url.externa:	http://www.scielo.br/pdf/ramb/v63n10/0104-4230-ramb-63-10-0899.pdf
metadata.dc.relation.ispartof:	Revista da Associação Médica Brasileira
Appears in Collections:	Artigo de Periódico

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