Nasal corticotherapy in children with allergic rhinitis - What effect on hypothalamic-pituitary-adrenal axis and growth?
DOI:
https://doi.org/10.34631/sporl.450Keywords:
allergic rhinitis, children, nasal corticosteroids, systemic side effects, hypothalamic-pituitary-adrenal axis, growthAbstract
Objective: To review the literature concerning the safety of nasal corticosteroids in the treatment of allergic rhinitis in children, emphasizing the risk of hypothalamic-pituitary-adrenal axis suppression and growth retardation.
Material and methods: We reviewed scientific articles published between 2000 and 2010, excluding those describing the use of corticotherapy for any disease other than allergic rhinitis.
Results: The second generation nasal corticosteroids (fluticasone and mometasone) have a reduced risk of systemic side effects, due to lower bioavailability. We found that no nasal corticosteroids were associated with hypothalamic-pituitary-adrenal axis suppression in the recommended doses; although we found two studies implicating beclomethasone and budesonide with significant growth retardation, they did not observe the effect on final height.
Conclusion: Nasal corticosteroids do not appear to affect growth significantly in children and thus should be included in the treatment of allergic rhinitis, however with periodic monitoring of growth.
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