Adrenal Suppression and Cushing’s Syndrome Secondary to Ritonavir and Inhaled Budesonide

¹Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, Houston, Texas, USA

Corresponding Author: Reuben Arasaratnam, Department of Medicine, Section of Infectious Diseases, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA, Tel: 713-798-6907; E-Mail: [email protected]

Received Date: 04 Jan 2016 
Accepted Date: 01 Feb 2016 
Published Date: 19 Feb 2016

Copyright © 2016 Arasaratnam RJ and Patel SM

Citation: Reuben JA and Patel SM. (2016). Adrenal Suppression and Cushing's Syndrome Secondary to Ritonavir and Inhaled Budesonide. Mathews J HIV AIDS. 1(1): 003.

ABSTRACT

A 65 year old male with HIV and COPD developed Cushing's syndrome and adrenal suppression after receiving low-dose inhaled budesonide and ritonavir. Discontinuation of ritonavir led to improvement in Cushingoid complications, however evidence of adrenal suppression still persisted 6 months later. Low-dose budesonide is often viewed as a safer alternative to fluticasone when inhaled corticosteroid therapy is required in a patients on ritonavir. Our case illustrates that patients receiving low-dose budesonide and ritonavir should also be considered at high risk of Cushingoid complications.

KEYWORDS

Ritonavir; Budesonide; Cushing's syndrome; Adrenal suppression.