Cushing syndrome with secondary adrenal insufficiency from concomitant therapy with ritonavir and fluticasone

We present 2 cases of Cushing syndrome with secondary adrenal insufficiency from concomitant use of ritonavir and inhaled corticosteroids in children with human immunodeficiency virus infection. These cases highlight the need for special consideration when treatment with an inhaled/intranasal cortic...

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Bibliographic Details
Published in:	The Journal of pediatrics Vol. 148; no. 3; pp. 386 - 388
Main Authors:	Johnson, Susan R., Marion, Alicia A., Vrchoticky, Teri, Emmanuel, Patricia J., Lujan-Zilbermann, Jorge
Format:	Journal Article
Language:	English
Published:	New York, NY Mosby, Inc 01-03-2006 Elsevier
Subjects:	Administration, Inhalation Adolescent Adrenal Insufficiency - chemically induced Adrenals. Adrenal axis. Renin-angiotensin system (diseases) Albuterol - administration & dosage Albuterol - adverse effects Albuterol - analogs & derivatives Androstadienes - administration & dosage Androstadienes - adverse effects Asthma - drug therapy Biological and medical sciences Bronchodilator Agents - administration & dosage Bronchodilator Agents - adverse effects Child Cushing Syndrome - chemically induced Drug Interactions Drug Therapy, Combination Endocrinopathies Female Fluticasone General aspects HIV Infections - drug therapy HIV Protease Inhibitors - administration & dosage HIV Protease Inhibitors - adverse effects Humans Medical sciences Non tumoral diseases. Target tissue resistance. Benign neoplasms Ritonavir - administration & dosage Ritonavir - adverse effects Salmeterol Xinafoate ART LPV EFV HIV RTV CYP 3A4 ACTH ICS PI BID HCRT PCP Endocrinopathy Corticosteroid Pediatrics Antiretroviral agent Secondary Adrenal cortex diseases Enzyme Ritonavir Antiinflammatory agent Cushing syndrome Enzyme inhibitor Hyperadrenocorticism Fluticasone Antiasthma agent Peptidases Adrenal insufficiency Treatment Adrenal gland diseases Hydrolases Antiviral Protease inhibitor
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Summary:	We present 2 cases of Cushing syndrome with secondary adrenal insufficiency from concomitant use of ritonavir and inhaled corticosteroids in children with human immunodeficiency virus infection. These cases highlight the need for special consideration when treatment with an inhaled/intranasal corticosteroid is indicated in children receiving antiretroviral therapy.
ISSN:	0022-3476 1097-6833
DOI:	10.1016/j.jpeds.2005.11.034