一名4岁患者在接受伊曲康唑和吸入性布地奈德联合治疗期间迅速发展为库欣综合征。
Rapidly developing Cushing syndrome in a 4-year-old patient during combined treatment with itraconazole and inhaled budesonide.
作者信息
De Wachter Elke, Vanbesien Jesse, De Schutter Iris, Malfroot Anne, De Schepper Jean
机构信息
Department of Paediatric Respiratory Medicine and Cystic Fibrosis Clinic, Vrije Universiteit Brussel, Brussels, Belgium.
Paediatric Endocrinology Clinic, Academisch Ziekenhuis-Vrije Universiteit Brussel (VUB), Laarbeeklaan 101, 1090 , Brussels, Belgium.
出版信息
Eur J Pediatr. 2003 Jul;162(7-8):488-489. doi: 10.1007/s00431-003-1233-8. Epub 2003 Apr 26.
UNLABELLED
A 4-year-old boy with cystic fibrosis developed hypertension, rapid weight gain and a moon face 2 weeks after starting a combined treatment of oral itraconazole and inhaled budesonide for a suspected allergic bronchopulmonary aspergillosis. Adrenal suppression was documented and found to persist 3 months after stopping this combined treatment.
CONCLUSION
To the best of our knowledge, this is the first time that an iatrogenic Cushing syndrome in a young child with cystic fibrosis after such combined treatment is reported. The inhibition of cytochrome P4503A by intraconazole and a higher glucocorticoid tissue sensitivity is suggested as the underlying mechanism.
未标注
一名4岁囊性纤维化男孩在开始联合使用口服伊曲康唑和吸入布地奈德治疗疑似变应性支气管肺曲霉病2周后，出现高血压、体重快速增加和满月脸。记录到肾上腺抑制，且在停止这种联合治疗3个月后仍持续存在。
结论
据我们所知，这是首次报道一名患有囊性纤维化的幼儿在接受这种联合治疗后发生医源性库欣综合征。推测潜在机制为伊曲康唑对细胞色素P4503A的抑制作用以及糖皮质激素组织敏感性较高。
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