Long‐term Treatment with Corticosteroids/ACTH in Asthmatic Children

Abstract

Skeletal maturation in severe bronchial asthma was studied in 15 children during and after treatment with depot tetracosactrin and in 6 children during treatment with prednisolone. Attained skeletal maturity before treatment was below the reference mean in the majority of children. Skeletal maturation was enhanced during treatment with depot tetracosactrin, which led to more advanced attained skeletal maturity at withdrawal than at start of treatment. There was a tendency towards larger increases of skeletal maturity than of height. The influence of adrenal androgens, released by ACTH-stimulation and good control of the disease are probably relevant factors for the acceleration of skeletal maturation. After withdrawal of depot tetracosactrin the rate of skeletal maturation normalized. During prednisolone treatment there was a delay of skeletal maturation leading to a progressive relative decrease of attained skeletal maturity, and closely related to a delay in linear growth. Treatment with depot tetracosactrin may thus induce enhancement of skeletal maturation, but with the treatment regimen found to be efficacious in bronchial asthma, the effect is not very pronounced and does not perceptibly affect the ultimate outcome of growth.

Impaired adrenal function after glucocorticoid therapy in children with acute lymphoblastic leukemia

“…Some studies have found the recovery time to depend on the glucocorticoid dose and length of treatment [7][8][9] while others have not [10][11][12]. Previous studies in children with ALL have indicated that the adrenal function usually recovers within the first weeks after abrupt cessation of high-dose glucocorticoid therapy, but may occasionally remain suppressed up to 8 weeks [13][14][15].…”

Long‐term Treatment with Corticosteroids/ACTH in Asthmatic Children

“…This might be due to the enhanced release of cortisol counteracting the insulin effect (27). In addition, some of the patients showed excessive weight gain during treatment (28), and it is known that insulin resistance occurs frequently in obesity (29).…”

Inhaled Steroids and Adrenal Function in Asthmatic Children

“…(1)(2)(3)(4)(5)(6)(7)(8) The main advantage of inhaled steroid therapy lies in the lack of systemic effects; growing evidence in¬ dicates that inhaled beclomethasone dipropionate (BDP) decreases airway hyper-reactivity and it is highly effective in controlling asthmatic symptoms. '9-14' One of the most important side-effects of inhaled steroids is their capacity to suppress the hypothalamicpituitary-adrenal ( ) axis; several studies on inhaled steroids have been divided on the occurrence of adrenal suppression; some find none and others find that it occurs at high doses.…”