İlke MUNGAN, Murat ÇAKIR, Fazıl ORHAN, Ayşenur ÖKTEN, İlknur AĞIRMAN

Topikal steroid kullanımına bağlı iyatrojenik Cushing sendromumi

Glukokortikoidler bir çok deri hastalığınm tedavisinde yaygın olarak kullanılmakla beraber, bazı hastalarda geri dönüşümlü hipotalamo-pituiter-' adrenal yolunun baskilanmasma neden olabilirler. Burada aşın dozda topikal kortikosteroid kullanımı sonucu Cushing sendromu gelişen 6 aylık kız hasta sunulmuştur.

Iatrogenic Cushing syndrome secondary to topical steroids

Although glucocorticoids are frequently used for a wide variety of skin diseases, sometimes they may cause reversible hypothalamic-pituitary-adrenal axis suppression in some patients. Here, we report a 6-month-old girl with Cushing syndrome that developed secondary to inappropriate topical corticosteroid use.

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1) Akan T. Topikal kortikosteroidlerin kullanımı. Katkı Pediatri Dergisi 2000; 21: 599- 604.
2) Ray DW. Molecular mechanisms of glucocorticoid resistance. J Endocrinol 1996; 149: 1- 5.
3) Ellison JA, Patel L, Ray DW, David TJ, Clayton PE. Hypothalamic- pituitary-adrenal function and glucocorticoid sensitivity in atopic dermatitis. Pediatrics 2000; 105: 794- 9.
4) Akşit S. Diaper Dermatit STED 2001; 10: 328- 9.
5) Gaillarg RC. Neuroendocrine regulation. In: Bertrand J, Rappaport R, Sizonenkp PC (eds). Pediatric Endocrinology. 2 nd edition. USA: Williams & Wilkins, 1993; 19- 45.
6) Keller-Wood ME, Dallman MF. Corticosteroid inhibition of ACTH secretion. Endoc Rev 1984; 5: 1- 14.
7) Ermis B, Ors R, Tastekin A, Ozkan B. Cushing's syndrome secondary to topical corticosteroids abuse. Clin Endocrinol. 2003; 58: 795- 6.
8) De Wachter E, Vanbesien J, De Schutter I, Malfroot A, De Schepper J. Rapidly developing Cushing syndrome in a 4- year-old patient during combined treatment with itraconazole and inhaled budesonide. Eur J Pediatr. 2003;162: 488- 9.
9) Haramura B, Tanaka A, Akimoto T, Hirayama N. Crystal structure of clobetasol propionate. Analytical Sciences 2003; 19: 37- 8.
10) Olsen EA, Cornell RC. Topical clobetasol-17-propionate: review of its clinical efficacy and safety. J Am Acad Dermatol 1986; 15: 246- 55.
11) Ohman EM, Rogers S, Meenan FO, McKenna TJ. Adrenal suppression following low-dose topical clobetasol propionate. J R Soc Med. 1987; 80: 422- 4.