Inhaled corticosteroids (ICS) have fundamentally changed the management of patients with asthma and play an important part in the management of chronic obstructive pulmonary disease (COPD)—the two most common chronic lung diseases.¹ These drugs are generally safe, but one of their most concerning side-effects is adrenal insufficiency, which can result in weakness, poor growth, hypoglycaemia, hypotension, and death. Although clinically evident adrenal insufficiency is rare, particularly in adults,^2,3 biochemical evidence of hypothalamic-pituitary-adrenal axis suppression—particularly in children—is not.

中文翻译：

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肾上腺功能不全和ICS：遗传学令人屏息

吸入糖皮质激素（ICS）从根本上改变了哮喘患者的治疗方式，并且在慢性阻塞性肺疾病（COPD）（这是两种最常见的慢性肺疾病）的治疗中起着重要作用。¹这些药物通常是安全的，但最令人担忧的副作用之一是肾上腺功能不全，可能导致虚弱，生长不良，低血糖，低血压和死亡。尽管临床上明显的肾上腺功能不全很少见，特别是在成年人中，但下丘脑-垂体-肾上腺轴抑制的生化证据[ ^2,3]（尤其是在儿童中）并不罕见。