Joshi Rohan R, Maresh Alison
Weill Cornell Medical College, 428 East 72nd Street, Oxford Building, Suite 100, New York, NY 10021, USA.
Int J Pediatr Otorhinolaryngol. 2018 Feb;105:123-126. doi: 10.1016/j.ijporl.2017.11.007. Epub 2017 Nov 11.
The use of intranasal steroid drops for nasal obstruction in infants is common practice and can prevent more invasive surgical procedures; however, it is not without complication. We describe 2 cases of iatrogenic Cushing's secondary to nasal steroids in infants with nasal obstruction, discuss the etiology of this unusual complication, and review previous literature reports. While reporting in the literature is sparse, these cases highlight the risk of development of adrenal insufficiency with usage of nasal steroid drops in infants as well as the need for close monitoring of administration and tapering of the drops. Additionally, we suggest an approach to the infant with symptomatic nasal obstruction that addresses the usage of intranasal steroid drops and emphasizes the need for quick tapering and possible endocrine consultation when appropriate.
使用鼻内类固醇滴鼻剂治疗婴儿鼻塞是常见做法，可避免更具侵入性的外科手术；然而，这并非没有并发症。我们描述了2例因鼻塞使用鼻内类固醇导致医源性库欣综合征的婴儿病例，讨论了这种罕见并发症的病因，并回顾了既往文献报道。虽然文献报道稀少，但这些病例凸显了婴儿使用鼻内类固醇滴鼻剂发生肾上腺功能不全的风险，以及密切监测用药和逐渐减少滴鼻剂用量的必要性。此外，我们提出了一种针对有症状鼻塞婴儿的处理方法，该方法涉及鼻内类固醇滴鼻剂的使用，并强调了快速减量以及在适当情况下可能需要内分泌会诊的必要性。
