Table 1 Main characteristics of a child who developed transient symptomatic hyperglycaemia during treatment with a moderate dose of inhaled fluticasone propionate (FP)
From: Transient symptomatic hyperglycaemia secondary to inhaled fluticasone propionate in a young child
Characteristic | Patient |
|---|---|
Age | 2 years |
Gender | Male |
Previous personal history | Recurrent asthmatic bronchitis and atopic dermatitis |
Familial history | Father with allergic asthma induced by inhaled allergens, uncle with coeliac disease, no other history of immune-mediated disease in the family |
Allergic tests | IgE levels of 124 KU/L, skin prick testing negative for standard food and inhaled allergens |
Therapies in the past year | Repeated courses of 100 μg inhaled FP twice a day for 7 days and then 50 μg twice a week for 3 days during acute events; oral corticosteroids in three cases |
Therapy at hyperglycaemia onset | 100 μg inhaled FP twice a day from October 1, 2014, to November 27, 2014 |
Symptoms at emergency room admission | Whining and agitation with increased diuresis and water intake |
Clinical signs at admission | Whining and agitation, no sign suggestive of acute infection, normal respiratory evaluation |
Laboratory evaluation | |
Glycaemia | 181 mg/dL |
Glycosuria | Present |
Blood gas analysis | pH 7.49, bicarbonates 31 mmol/L, pCO2 39 mmHg, sodium 135 mEq/L, potassium of 3.5 mEq/L |
Oral glucose tolerance test | Normal |
Glycated haemoglobin | 7 % |
Treatment | Endovenous infusion of physiological saline for 48 h |
Persistence of symptoms | 6 h |
Outcome | Replacement of inhaled FP therapy with oral 4 mg montelukast once a day, no further hyperglycaemia episodes after 6 months |