Long‐term Treatment with Corticosteroids/ACTH in Asthmatic Children

Abstract

Hypothalamic-pituitary-adrenal (HPA) function was studied in 23 children with severe bronchial asthma during and after long-term treatment with prednisolone and/or ACTH1-24 depot tetracosactrin) by means of ACTH stimulation test and insulin tolerance test. In the 14 children primarily treated with depot tetracosactrin, the cortisol levels in insulin tests were within normal limits both during and after treatment. An enhanced response to ACTH stimulation was found during the treatment period. During treatment with prednisolone a marked impairment of the adrenocortical function was found, with low basal plasma cortisol levels and subnormal response to ACTH stimulation, more marked the lower the age at the start of treatment and the higher the dose per kg body weight. After substitution with depot tetracosactrin the HPA-function was restituted, with plasma cortisol levels within normal limits. Growth hormone levels after insulin induced hypoglycemia were greater than or equal to 7 ng/ml during and after treatment with depot tetracosactrin. As long-term treatment with depot tetracosactrin has little side-effects in terms of suppression of the HPA-axis it is a useful alternative to oral prednisolone in severe asthma in children.

A Method for Adjustment of Final Height for Midparental Height for Swedish Children

“…It can be useful when assessing the long-term effect on height of growth related disorders in Swedish children. For instance, it has been used in comparing the final heights following the application of two different medical regimens (corticosteroids and ACTH) given during childhood to asthmatic children (3). Methods for adjustment of final height for midparental height have been given previously.…”

Budesonide delivered by dosimetric jet nebulization to preterm very low birthweight infants at high risk for development of chronic lung disease

“…Aerosolized corticosteroids are commonly used in childhood asthma and have shown minimal side effects compared to systemic corticosteroids (8)(9)(10). Studies examining the effect of aerosolized corticosteroids in neonates have shown bene cial effects on lung mechanics without reported side effects (11)(12)(13)(14)(15).…”