Corticoterapia nasal em crianças com rinite alérgica - Que efeito no eixo hipotálamo-hipófise-supra-renal e no crescimento?
DOI:
https://doi.org/10.34631/sporl.450Palavras-chave:
rinite alérgica, crianças, corticóides nasais, efeitos adversos sistémicos, eixo hipotálamo-hipófise-suprarenal, crescimentoResumo
Objectivo: Revisão da literatura referente à segurança da corticoterapia nasal no tratamento da rinite alérgica em crianças, enfatizando o risco de supressão do eixo hipotálamo-hipófise-supra-renal e de atraso de crescimento.
Material e métodos: Pesquisa de artigos científicos publicados entre 2000 e 2010, excluindo-se os referentes à corticoterapia nasal no tratamento de qualquer outra patologia que não a rinite alérgica. Resultados: Os corticóides nasais de segunda geração (fluticasona e mometasona) associam-se a um menor risco de efeitos adversos sistémicos, pela menor biodisponibilidade que apresentam. Nenhum corticóide nasal se associou a supressão do eixo hipotálamo-hipófise-supra-renal em doses recomendadas; dois estudos implicaram beclometasona e budesonido num atraso de crescimento estatisticamente significativo, embora não seja conhecido o efeito na estatura final.
Conclusão: Os corticóides nasais não parecem afectar de forma significativa o crescimento, pelo que devem ser incluídos na terapêutica da rinite alérgica em crianças, não descurando a importância da monitorização periódica do crescimento.
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