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口服粘性布地奈德治疗儿童嗜酸性食管炎时的肾上腺抑制

Adrenal Suppression in Children Treated With Oral Viscous Budesonide for Eosinophilic Esophagitis.

作者信息

Harel Shira, Hursh Brenden E, Chan Edmond S, Avinashi Vishal, Panagiotopoulos Constadina

机构信息

*Endocrinology and Diabetes Unit †Division of Allergy and Immunology, Department of Pediatrics ‡Division of Pediatric Gastroenterology, Hepatology and Nutrition, British Columbia Children's Hospital, University of British Columbia, Vancouver, BC.

出版信息

J Pediatr Gastroenterol Nutr. 2015 Aug;61(2):190-3. doi: 10.1097/MPG.0000000000000848.

Abstract

We sought to determine the prevalence of adrenal suppression (AS) in children with eosinophilic esophagitis treated with oral viscous budesonide (OVB). This was a retrospective review of a quality assurance initiative, whereby all children in our center treated with OVB for ≥3 months were referred over an 18-month time frame for endocrine assessment including 1 μg adrenocorticotropic hormone stimulation test. Fourteen of 19 children complied with the referral; of these 14 children, 6 (43%) had suboptimal stimulated cortisol (range 343-497 nmol/L, mean [±SD] 424.7 nmol/L [±52.4], normal ≥500 nmol/L). There was no significant association to treatment duration, dose, or concomitant use of inhaled/nasal corticosteroids. This study suggests that children treated with OVB may be at risk for AS.

摘要

我们试图确定接受口服粘性布地奈德(OVB)治疗的嗜酸性食管炎儿童中肾上腺抑制(AS)的患病率。这是一项对质量保证计划的回顾性研究,在此期间,我们中心所有接受OVB治疗≥3个月的儿童在18个月的时间内被转诊进行内分泌评估,包括1μg促肾上腺皮质激素刺激试验。19名儿童中有14名遵守了转诊要求;在这14名儿童中,6名(43%)的刺激后皮质醇水平未达最佳(范围为343 - 497 nmol/L,平均[±标准差]为424.7 nmol/L [±52.4],正常水平≥500 nmol/L)。这与治疗持续时间、剂量或吸入/鼻用皮质类固醇的同时使用无显著关联。这项研究表明,接受OVB治疗的儿童可能存在肾上腺抑制风险。

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