Abstract
The case is a 4-year-old girl, diagnosed as having asthma. Wheezing was repeated even after the start of a treatment with leukotriene receptor antagonist and inhaled corticosteroid. Therefore, she was received systemic administration of corticosteroids for a long term. The total dose of corticosteroids was more than 1000mg in almost 3 months until she was admitted to our hospital. After hospitalization, the dose of systemic steroid was tapered down to the basal cortisol level, but asthma symptoms were not exacerbated. She has been diagnosed with moderate gastroesophageal reflux (GER) from the result of esophageal pH monitoring, wheezing was improved after start of the therapy of GER. Her adrenal function was not recovered three weeks after administration, and early morning level of cortisol was lower than basal secretion level. It took five months for stop of the oral steroid medicine, and seven months for the complete recovery of the adrenal function.
In infantile asthma, we should be taken to examine carefully of the possibility of differential diagnosis. If we consider the adaptation of long-term glucocorticoid therapy for childhood asthma, be careful of the adverse effects of adrenal function.
