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Growth impairment and adrenal suppression on low-dose inhaled beclomethasone

Savitha D Shenoy1, Shruthakrithi D Shenoy, Peter Gf Swift

  • 1Children's Hospital, Leicester Royal Infirmary, UK.

Journal of Paediatrics and Child Health
|March 3, 2006
PubMed

Insights

Long-term inhaled corticosteroid (ICS) use in children can cause growth impairment and adrenal suppression, even at low doses. Careful monitoring is essential due to individual sensitivity to these asthma medications.

Area of Science:

  • Pediatric Endocrinology
  • Respiratory Medicine
  • Pharmacology

Background:

  • Inhaled corticosteroids (ICS) are standard treatment for persistent asthma.
  • While generally safe, potential side effects include growth impairment and adrenal suppression.
  • Low-dose ICS are often presumed to have minimal systemic effects.

Observation:

  • A 13-year-old boy with asthma on long-term low-dose beclomethasone (200 microg/d) presented with short stature.
  • Clinical evaluation revealed significant adrenal suppression.
  • This case highlights a potential adverse effect of ICS therapy.

Findings:

  • Discontinuation of inhaled corticosteroids led to the recovery of adrenal function.
  • The patient experienced a subsequent period of rapid growth.
  • This suggests a direct link between ICS exposure and the observed growth and adrenal issues.

Implications:

  • Individual sensitivity to ICS varies greatly, even at low doses.
  • Routine monitoring for growth and adrenal function is crucial in children on long-term ICS.
  • This case underscores the importance of vigilant surveillance for steroid side effects in pediatric asthma management.

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