利托那韦与局部眼用皮质类固醇诱发一名感染HIV-1的青少年患库欣综合征
Ritonavir and Topical Ocular Corticosteroid Induced Cushing's Syndrome in an Adolescent With HIV-1 Infection.
作者信息
Rainsbury Paul G, Sharp Jessica, Tappin Alison, Hussey Martin, Lenko Alexandra, Foster Caroline
机构信息
From the *University Hospital Southampton, Southampton, Hampshire, United Kingdom; †NHS Foundation Trust, United Kingdom; ‡Imperial College London, Kensington, London, United Kingdom; §Portsmouth Hospitals, Portsmouth, United Kingdom; and ¶Poole Hospitals, Poole, United Kingdom.
出版信息
Pediatr Infect Dis J. 2017 May;36(5):502-503. doi: 10.1097/INF.0000000000001534.
Cushing's syndrome after topical ocular corticosteroid use is extremely rare. We describe a case of symptomatic Cushing's syndrome in an adolescent male with sight-threatening vernal keratoconjunctivitis on antiretroviral therapy for HIV-1 infection that included ritonavir, a potent cytochrome p450 CYP3A4 inhibitor. CYP3A4 inhibition reduces the metabolism of exogenous corticosteroids leading to suppression of endogenous steroid production and Cushing's syndrome.
局部眼部使用皮质类固醇激素后发生库欣综合征极为罕见。我们描述了一例患有威胁视力的春季角结膜炎的青少年男性发生症状性库欣综合征的病例，该患者正在接受抗逆转录病毒治疗以治疗HIV-1感染，治疗方案中包括利托那韦，一种强效细胞色素P450 CYP3A4抑制剂。CYP3A4抑制作用会降低外源性皮质类固醇激素的代谢，导致内源性类固醇激素分泌受抑制，进而引发库欣综合征。
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