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Reproducibility and utility of an overnight 0.25 mg dexamethasone suppression test as a marker for glucocorticoid sensitivity in children with asthma.
Willemsen, R H; van Leeuwen, L; Voorend-van Bergen, T A S; de Rijke, Y B; Pijnenburg, M W; van den Akker, E L T.
Afiliación
  • Willemsen RH; Department of Paediatric Endocrinology, Erasmus MC Sophia, 3015 GJ, Rotterdam, The Netherlands. rw490@medschl.cam.ac.uk.
  • van Leeuwen L; Department of Paediatrics, Box 116 Level 8 Addenbrooke's Hospital, University of Cambridge, Cambridge Biomedical Campus, Hills Road, Cambridge, CB2 0QQ, UK. rw490@medschl.cam.ac.uk.
  • Voorend-van Bergen TA; Department of Paediatric Endocrinology, Erasmus MC Sophia, 3015 GJ, Rotterdam, The Netherlands.
  • de Rijke YB; Department of Paediatric Pulmonology, Erasmus MC Sophia, 3015 GJ, Rotterdam, The Netherlands.
  • Pijnenburg MW; Diagnostic Laboratory Endocrinology, Departments of Clinical Chemistry and Internal Medicine, Erasmus MC, 3015 GJ, Rotterdam, The Netherlands.
  • van den Akker EL; Department of Paediatric Pulmonology, Erasmus MC Sophia, 3015 GJ, Rotterdam, The Netherlands.
J Endocrinol Invest ; 39(1): 93-6, 2016 Jan.
Article en En | MEDLINE | ID: mdl-26059835
PURPOSE: Inhaled corticosteroids (ICS) are the cornerstone of asthma treatment in children. However, there is considerable inter-individual variation in glucocorticoid sensitivity, leading to over- as well as undertreatment. A simple and fast test to predict glucocorticoid sensitivity would enable more tailored therapy in children with asthma. AIM: To study reproducibility and utility of an overnight 0.25 mg dexamethasone suppression test (DST) with salivary cortisol levels as marker for glucocorticoid sensitivity in asthmatic children. METHODS: 23 children with atopic asthma were recruited for two overnight 0.25 mg DST's, 1 month apart. RESULTS: Baseline cortisol levels correlated well between both tests. However, cortisol levels, change in cortisol levels or fractional suppression of cortisol levels after dexamethasone did not correlate between the two tests. Bland-Altman plots showed that the difference in salivary cortisol levels between test 1 and 2 of an individual patient could go up to 12 nmol/l, which is a clinically relevant difference. ICS dose did not correlate with baseline cortisol levels, height and BMI SDS. CONCLUSION: The low-dose salivary DST test in its current form is not suitable for use in clinical practice in children with asthma, due to low reproducibility. Therefore, studies using the 0.25 mg salivary DST should be interpreted cautiously.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Asma / Resistencia a Medicamentos / Dexametasona / Hidrocortisona / Glucocorticoides Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: J Endocrinol Invest Año: 2016 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Italia
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Asma / Resistencia a Medicamentos / Dexametasona / Hidrocortisona / Glucocorticoides Tipo de estudio: Diagnostic_studies / Prognostic_studies Límite: Adolescent / Child / Female / Humans / Male Idioma: En Revista: J Endocrinol Invest Año: 2016 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Italia