Esophageal Candidiasis Associated with Beclomethasone Dipropionate Aerosol Therapy

Kesten, Steven; Hyland, Robert H.; Pruzanski, W.; Kortan, Paul P.

doi:10.1177/106002808802200709

Cited by 12 publications

(4 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The first cases of esophageal candidiasis were reported in the late 1970's and were associated with beclometasone (9, 10). However, the first case with lasting impact in medical literature was reported in 1988: a 23-year-old woman, treated with 400 mcg/day of inhaled beclometasone (11). Yet, this patient also suffered from hypogamaglobulinemia with IgG 596 mg/dL, and normal levels of IgA and IgM.…”

Section: Discussionmentioning

confidence: 95%

Esophageal Candidiasis—An Adverse Effect of Inhaled Corticosteroids Therapy

et al. 2009

View full text Add to dashboard Cite

Over the last few decades, inhaled corticosteroids (ICs) became the cornerstone in the treatment of persistent asthma. Their use improved asthma control, decreased mortality and also minimized adverse reactions associated with systemic steroid. Esophageal candidiasis is a rare complication resulting from the use of ICs. Although, in recent years, as their prescriptions has increased, more cases have been reported, especially in Japan. Listed are 4 case reports regarding esophageal candidiasis in asthmatic patients associated with inhaled budesonide administration. In the cases reported herein, the use of a different device of dry powder budesonide might have favored esophageal drug deposition and Candida infection. Patients denied using systemic corticosteroids in the previous 6 months. Furthermore, none of the patients presented Diabetes mellitus, malignant disease, HIV infection, or other immunosuppressive conditions. We conclude that patients treated with high doses of ICs are at higher risk of developing esophageal candidiasis. These patients should undergo upper gastrointestinal endoscopy whenever they present symptoms. Nevertheless, we must keep in mind that infection might also be asymptomatic and esophageal candidiasis prevalence may be higher than that reported thus far.

show abstract

Section: Discussionmentioning

confidence: 95%

Esophageal Candidiasis—An Adverse Effect of Inhaled Corticosteroids Therapy

et al. 2009

View full text Add to dashboard Cite

show abstract

“…Systematically administered corticosteroids predispose to infection by suppressing both lymphocyte and granulocyte function (10). Inhaled corticosteroids may be deposited in the oesophagus after swallowing and facilitate subsequent colonisation and infection with Candida (11–14).…”

Section: Introductionmentioning

confidence: 99%

Predisposing factors and clinical symptoms in HIV-negative patients with Candida oesophagitis: are they always present?

Mimidis¹,

Papadopoulos²,

Margaritis³

et al. 2004

International Journal of Clinical Practice

View full text Add to dashboard Cite

Candida oesophagitis (CO) is scarce among immunocompetent patients. This study aimed at evaluating predisposing factors, clinical symptoms and endoscopic findings in this group. We retrospectively reviewed 55 patients diagnosed as CO endoscopically (whitish plaques) and cytologically (fungal mycelia on brush cytology). Carcinoma, diabetes, acid suppression, steroids, gastric surgery and oesophageal motility disorders were considered as predisposing factors. Twenty of 55 patients lacked any predisposing factor for CO. These patients were more frequently asymptomatic (8/20) when compared with those with known predisposing factors (5/35) (p = 0.031). Moreover, dysphagia was more prevalent in the latter group (24/35 vs. 8/20; p = 0.039). Endoscopic findings correlated with the presence of neither predisposing factors nor symptoms (Wilcoxon p > 0.05). Thus, CO can be discovered in patients without apparent predisposing risk factors and clinical symptoms. Further studies are needed to elucidate the mechanisms of transition from colonisation to infection.

show abstract

“…11,31 The use of BDP inhalers has been associated with oropharyngeal and esophageal candidiasis, 42,43 but oral delivery of BDP did not result in an increased incidence of fungal or bacterial colonization or infections after HCT. 11,31 Metabolites of BDP are systemically bioavailable, resulting in decreased adrenal responsiveness over time of drug exposure.…”

Section: Discussionmentioning

confidence: 99%

A randomized, placebo-controlled trial of oral beclomethasone dipropionate as a prednisone-sparing therapy for gastrointestinal graft-versus-host disease

Hockenbery

Cruickshank

Rodell

et al. 2007

Blood

109

View full text Add to dashboard Cite

We tested the hypothesis that oral beclomethasone dipropionate (BDP) would control gastrointestinal graft-versus-host disease (GVHD) in patients with anorexia, vomiting, and diarrhea. Patients were randomized to prednisone for 10 days and either oral BDP 8 mg/d (n ‫؍‬ 62) or placebo (n ‫؍‬ 67) tablets for 50 days. At study day 10, prednisone was rapidly tapered while continuing study drug. On an intentto-treat basis, the risk of GVHD-treatment failure was reduced for the BDP group at study day 50 (hazard ratio [

show abstract

Esophageal Candidiasis Associated with Beclomethasone Dipropionate Aerosol Therapy

Cited by 12 publications

References 10 publications

Esophageal Candidiasis—An Adverse Effect of Inhaled Corticosteroids Therapy

Esophageal Candidiasis—An Adverse Effect of Inhaled Corticosteroids Therapy

Predisposing factors and clinical symptoms in HIV-negative patients with Candida oesophagitis: are they always present?

A randomized, placebo-controlled trial of oral beclomethasone dipropionate as a prednisone-sparing therapy for gastrointestinal graft-versus-host disease

Contact Info

Product

Resources

About