Oral corticosteroids for asthma exacerbations might be associated with adrenal suppression: Are physicians aware of that?

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dc.creatorCristina Botelho Barra
dc.creatorMaria Jussara Fernandes Fontes
dc.creatorMarco Túlio Gualberto Cintra
dc.creatorJanaina Andrade Guimarães
dc.creatorM.c.c. Guimarães
dc.creatorRenata Campos da Cruz
dc.creatorIvani Novato Silva
dc.date.accessioned2023-08-07T19:42:25Z
dc.date.accessioned2025-09-08T23:12:09Z
dc.date.available2023-08-07T19:42:25Z
dc.date.issued2017-05-02
dc.format.mimetypepdf
dc.identifier.doihttps://doi.org/10.1590/1806-9282.63.10.899
dc.identifier.issn0104-4230
dc.identifier.urihttps://hdl.handle.net/1843/57565
dc.languageeng
dc.publisherUniversidade Federal de Minas Gerais
dc.relation.ispartofRevista da Associação Médica Brasileira
dc.rightsAcesso Aberto
dc.subjectAsma
dc.subjectCorticosteroides
dc.subjectSupressão
dc.subjectCriança
dc.subject.otherAsthma
dc.subject.otherCorticosteroids
dc.subject.otherSuppression
dc.subject.otherChild
dc.titleOral corticosteroids for asthma exacerbations might be associated with adrenal suppression: Are physicians aware of that?
dc.typeArtigo de periódico
local.citation.epage903
local.citation.issue10
local.citation.spage899
local.citation.volume63
local.description.resumoIntroduction: 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.
local.identifier.orcidhttps://orcid.org/0000-0003-3089-655X
local.publisher.countryBrasil
local.publisher.departmentMED - DEPARTAMENTO DE CLÍNICA MÉDICA
local.publisher.departmentMED - DEPARTAMENTO DE PEDIATRIA
local.publisher.initialsUFMG
local.url.externahttp://www.scielo.br/pdf/ramb/v63n10/0104-4230-ramb-63-10-0899.pdf

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