Abstract
Corticosteroids cause growth disorder not only by impairing the GH/IGF-1 axis but also by interfering with cartilage growth plates directly. Even modest doses of corticosteroids as low as 3 mg/m2 per day of prednisolone can suppress linear growth. Regarding inhaled corticosteroids (ICS), recent randomized cohort study revealed that the mean adult height was 1.2 cm reduced in patients treated with budesonide. However, as ICS is established as the first-line therapy for children with persistent asthma, the accompanying slight growth suppression may be justified so long as its efficacy surpasses it. Regarding oral corticosteroids, severe adverse events resulting from prolonged use of Celestamine®, a fixed-dose combination of betamethasone and d-chlor-pheniramine malate, are reported from various institutions. Growth disorder is observed in more than 70% of the reported cases. To prevent growth suppression resulting from the administration of corticosteroids, it is essential to examine the efficacy, toxicity, necessity, and replaceability of the drug and to minimize the total amount and duration of the medication.
