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SELECTED ARTICLES FROM THE RECENT LITERATURE 2006
10/27/06
Osteoporosis and adrenal suppression during oral corticosteroid treatment of nasal polyposis
Summary
Background – Patients with severe nasal polyposis (NP) frequently require at least intermittent treatment with oral corticosteroids (CS) in addition to other treatment.
Findings – Bonfils et al evaluated the risk for osteoporosis and suppression of the HPA axis in the patients with severe NP requiring at least 3 courses of oral CS (cumulative >21 days/year starting at 1 mg/kg/day. Asthma was present in 78% and aspirin sensitivity was present in 28%.
After a one year follow -up, osteoporosis was present in 11%, and osteopenia in 44%. Asymptomatic HPA axis suppression was found in 49%.
Reference
Acta Otolaryngol 2006;126:1195-1200
Editor's Comments
These findings, although in an uncontrolled study, do point to the hazards involved in even intermittent systemic CS treatment for NP. It is understandable why systemic CS treatment is resorted to at times to give patients with severe NP some reasonable degree of comfort. Intranasal CS therapy may maintain improvement induced by systemic CS if the NP problem is not too severe. However, symptomatic NP relapses after withdrawal from systemic CS treatment (and even after polypectomy) occur frequently.
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