Iatrogenic Cushing Syndrome and Hypertension in An Infant Girl due to Use Of Nappy Rash Cream Containing A Potent Topical Steroid

Iatrogenic Cushing Syndrome And Hypertension In An Infant Girl Due To Use Of Nappy Rash Cream Containing A Potent Topical Steroid.

• Saima Gillani
• Burhan Ali Danish
• Syed Faiz Muhammad Shah
• Fawad Hussain
• Farida Aziz
• Attia Iqbal

抄録

生後11ヶ月の女性患者は、顔面の腫れを心配して小児科外来を受診した。診察の結果、体重と身長は年齢の割には正常であり、全身の水腫はなく、筋肉の衰えを伴う求心性肥満が見られたが、頬の胸部に多孔性のクッション状の顔面（図-1,2）を有していた（図-3,4）。全身検査は年齢の割に血圧が高かった以外は正常であった。電解質、コルチゾール値は正常であった。さらに調べてみると、彼女は強力なステロイド、すなわちフルチカゾンを含むおむつかぶれクリームを2ヶ月間使用していたことが明らかになり、これが彼女のクシンゴイドの特徴の原因であることが特定されました。

Eleven months old female patient presented to paediatric out patient with parents concerned about her facial swelling. Upon examination child's weight and height for age were normal on her percentiles, she had a cushingoid facies with plethoric cheeks (Figure-1,2) though generalized oedema was absent and there was centripetal obesity with some muscle wasting (Figure-3,4). Systemic examination was normal excluding blood pressure which was high for her age. Electrolytes and cortisol levels were normal. On further inquiry it was revealed that she had been using a nappy rash cream containing a potent steroid, i.e., fluticasone for 2 months and this was identified as a cause for her cushingoid features.