Mometasone Furoate–Induced Iatrogenic Cushing’s Syndrome and Secondary Adrenal Insufficiency: A Case Report
Intranasal corticosteroids (INCS) are widely used to treat allergic rhinitis and nasal obstruction. While their safety profile is generally well established, both local and systemic side effects can occur. While it is well-known that a chronic exposure to systemic glucocorticoid treatment could dete...
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| Format: | Article |
| Language: | English |
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Wiley
2025-01-01
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| Series: | Case Reports in Pediatrics |
| Online Access: | http://dx.doi.org/10.1155/crpe/6109378 |
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| author | Anna Insalaco Sara Vandelli Simona F. Madeo Patrizia Bruzzi Viola Trevisani Barbara Predieri Laura Lucaccioni Lorenzo Iughetti |
| author_facet | Anna Insalaco Sara Vandelli Simona F. Madeo Patrizia Bruzzi Viola Trevisani Barbara Predieri Laura Lucaccioni Lorenzo Iughetti |
| author_sort | Anna Insalaco |
| collection | DOAJ |
| description | Intranasal corticosteroids (INCS) are widely used to treat allergic rhinitis and nasal obstruction. While their safety profile is generally well established, both local and systemic side effects can occur. While it is well-known that a chronic exposure to systemic glucocorticoid treatment could determine Cushing’s syndrome (CS) and suppression of the hypothalamic–pituitary–adrenal (HPA) axis, there is less awareness when the administration is topical or intranasal. We report the case of an 8-year-old Caucasian girl who developed Cushingoid features following prolonged INCS treatment—initially with betamethasone and subsequently with mometasone furoate. Endocrine testing revealed undetectable baseline and after stimulation cortisol levels, suggesting a condition of adrenal insufficiency secondary to the prolonged glucocorticoid exogenous administration. Temporary hydrocortisone replacement therapy was required. Even if extremely rare, pediatricians should be aware that high-dose and long-term nasal steroid administration may cause iatrogenic CS, as well as systemic glucocorticoid treatment. Clinical features are characterized by the complications of glucocorticoid excess and by the potential life-threatening complications of adrenal insufficiency. Pediatric follow-up should be scheduled during the prolonged steroid treatment and at discontinuation, with prompt referral to a Pediatric Endocrinologist if signs and symptoms of CS (or adrenal insufficiency) are noticed. |
| format | Article |
| id | doaj-art-9a940468c7f24f9190aba8b3bbc1bd9b |
| institution | DOAJ |
| issn | 2090-6811 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Pediatrics |
| spelling | doaj-art-9a940468c7f24f9190aba8b3bbc1bd9b2025-08-20T03:16:12ZengWileyCase Reports in Pediatrics2090-68112025-01-01202510.1155/crpe/6109378Mometasone Furoate–Induced Iatrogenic Cushing’s Syndrome and Secondary Adrenal Insufficiency: A Case ReportAnna Insalaco0Sara Vandelli1Simona F. Madeo2Patrizia Bruzzi3Viola Trevisani4Barbara Predieri5Laura Lucaccioni6Lorenzo Iughetti7Department of Medical and Surgical Sciences for Mothers, Children and AdultsDepartment of Medical and Surgical Sciences for Mothers, Children and AdultsDepartment of Medical and Surgical Sciences for Mothers, Children and AdultsDepartment of Medical and Surgical Sciences for Mothers, Children and AdultsDepartment of Medical and Surgical Sciences for Mothers, Children and AdultsDepartment of Medical and Surgical Sciences for Mothers, Children and AdultsDepartment of Medical and Surgical Sciences for Mothers, Children and AdultsDepartment of Medical and Surgical Sciences for Mothers, Children and AdultsIntranasal corticosteroids (INCS) are widely used to treat allergic rhinitis and nasal obstruction. While their safety profile is generally well established, both local and systemic side effects can occur. While it is well-known that a chronic exposure to systemic glucocorticoid treatment could determine Cushing’s syndrome (CS) and suppression of the hypothalamic–pituitary–adrenal (HPA) axis, there is less awareness when the administration is topical or intranasal. We report the case of an 8-year-old Caucasian girl who developed Cushingoid features following prolonged INCS treatment—initially with betamethasone and subsequently with mometasone furoate. Endocrine testing revealed undetectable baseline and after stimulation cortisol levels, suggesting a condition of adrenal insufficiency secondary to the prolonged glucocorticoid exogenous administration. Temporary hydrocortisone replacement therapy was required. Even if extremely rare, pediatricians should be aware that high-dose and long-term nasal steroid administration may cause iatrogenic CS, as well as systemic glucocorticoid treatment. Clinical features are characterized by the complications of glucocorticoid excess and by the potential life-threatening complications of adrenal insufficiency. Pediatric follow-up should be scheduled during the prolonged steroid treatment and at discontinuation, with prompt referral to a Pediatric Endocrinologist if signs and symptoms of CS (or adrenal insufficiency) are noticed.http://dx.doi.org/10.1155/crpe/6109378 |
| spellingShingle | Anna Insalaco Sara Vandelli Simona F. Madeo Patrizia Bruzzi Viola Trevisani Barbara Predieri Laura Lucaccioni Lorenzo Iughetti Mometasone Furoate–Induced Iatrogenic Cushing’s Syndrome and Secondary Adrenal Insufficiency: A Case Report Case Reports in Pediatrics |
| title | Mometasone Furoate–Induced Iatrogenic Cushing’s Syndrome and Secondary Adrenal Insufficiency: A Case Report |
| title_full | Mometasone Furoate–Induced Iatrogenic Cushing’s Syndrome and Secondary Adrenal Insufficiency: A Case Report |
| title_fullStr | Mometasone Furoate–Induced Iatrogenic Cushing’s Syndrome and Secondary Adrenal Insufficiency: A Case Report |
| title_full_unstemmed | Mometasone Furoate–Induced Iatrogenic Cushing’s Syndrome and Secondary Adrenal Insufficiency: A Case Report |
| title_short | Mometasone Furoate–Induced Iatrogenic Cushing’s Syndrome and Secondary Adrenal Insufficiency: A Case Report |
| title_sort | mometasone furoate induced iatrogenic cushing s syndrome and secondary adrenal insufficiency a case report |
| url | http://dx.doi.org/10.1155/crpe/6109378 |
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