Vasconez F, Pérez-Garcia R, Olivas E, Bolívar J E, Valderrábano F
Med Clin (Barc). 1980 Dec 15;75(10):430-4.
A patient is reported who presented with severe arterial hypertension and pronounced hypokalemic metabolic alkalosis along with suppression of 17-hydroxicorticoids, plasma renin activity and urinary aldosterone excretion, in relation to topical application of 9-alpha-fluoroprednisolone, 300 mg weekly. The clinical picture changed after discontinuation of the steroid preparation. Whenever topical steroids are prescribed for extensive chronic skin the development of systemic side-effects must be watched. Depending on the type of steroid employed, Cushing's syndrome or a hypermineralcorticism state may appear. The differential diagnosis of a hypermineralcorticism syndrome without aldosteronism should include the possible topical application of fluorated steroids.
据报道,一名患者因每周局部应用300毫克9-α-氟泼尼松龙,出现严重动脉高血压、明显的低钾性代谢性碱中毒,同时伴有17-羟皮质类固醇、血浆肾素活性和尿醛固酮排泄受抑制。停用类固醇制剂后,临床症状有所改变。每当为广泛的慢性皮肤病开具局部类固醇药物时,必须留意全身副作用的发生。根据所用类固醇的类型,可能会出现库欣综合征或高盐皮质激素状态。无醛固酮增多症的高盐皮质激素综合征的鉴别诊断应包括氟化物类固醇局部应用的可能性。