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Adrenal responses to low dose synthetic ACTH (Synacthen) in children receiving high dose inhaled fluticasone
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Other responses

  • Published on:
    High-Dose Inhaled Fluticasone, Asthma, and Adrenal Insufficiency

    Dear Editor,

    Paton et al (1) described varying degrees of adrenal insufficiency in children treated with high-dose inhaled Fluticasone Propionate (FP) for asthma. They state “The attempts to reduce FP in the other children with flat responses resulted in unacceptable worsening of asthma symptoms, reflecting the value of high-dose FP in children with more severe asthma”. However, is it not the case that high-dose FP...

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    Conflict of Interest:
    None declared.
  • Published on:
    Compliance with inhaled corticosteroids is important when considering adrenal suppression

    Dear Editor,

    We read with interest the article by Paton and colleagues[1] reporting the results of low dose Synacthen tests in children prescribed fluticasone proprionate (FP). The finding of flat adrenal responses in 2.8% of children tested (all prescribed greater than or equal to 1,000 micrograms of FP per day) provides further evidence of the potential dangers of high doses.

    We recently published the...

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    Conflict of Interest:
    None declared.
  • Published on:
    Diagnostically, the low dose short synacthen test and the high dose test can complement each other

    Dear Editor,

    The concept utilised in this study,namely, that the low-dose short synacthen test(LDT)is more sensitive than the conventional high dose test(HDT)(1), should not rule out the use of the HDT, given the fact that the two tests can complement each other in the context of suspected secondary hypoadrenalism, depending on the pre-test probability of this disorder(2). The rationale is that the superior sensiti...

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    Conflict of Interest:
    None declared.