ESOPHAGEAL CANDIDIASIS AS COMPLICATION OF INHALED STEROID THERAPY
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Accession number;03A0868646
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| Title;ESOPHAGEAL CANDIDIASIS AS COMPLICATION OF INHALED STEROID THERAPY |
| Author;
SHUTO HIROSHI
(Kenshinkai Ekibiruiinsengendai)
NAGATA MAKOTO
(Saitamazensokuchiryokonwakai)
TERASHI YOSHINORI
(Saitamazensokuchiryokonwakai)
YAMAGUCHI MICHIYA
(Saitamazensokuchiryokonwakai)
TAKIZAWA TAKAO
(Saitamazensokuchiryokonwakai)
SHUTO CHIZURU
(Saitamatobuarerugikenkyukai)
WATANABE KENSUKE
(Saitamatobuarerugikenkyukai)
TOSAKA KAORU
(Saitamatobuarerugikenkyukai)
NOGUCHI HISASHI
(Tokyo Metrop. Ebara Hosp.)
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Journal Title;Japanese Journal of Allergology
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Journal Code:Z0644A
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ISSN:0021-4884
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VOL.52;NO.11;PAGE.1053-1064(2003)
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| Figure&Table&Reference;FIG.10, TBL.3, REF.24 |
| Pub. Country;Japan |
| Language;Japanese |
| Abstract;Gastrointestinal endoscopy was performed in two bronchial asthma patients using inhaled corticosteroid who complained of odynophagia. The endoscopic finding was high grade with white moss (Grade III) in both patients. Esophageal candidiasis is often recognized in bronchial asthmatic patients receiving long-term fluticasone propionate (FP) dry powder (Diskhaler) inhalation. We therefore examined the complicated context of esophageal candidiasis in patients with long-term FP inhalation. Out of 20 bronchial asthmatic patients who had been using FP inhalation long-term, seven showed signs of esophageal candidiasis. Three patients had mild grade (Grade I), one middle grade (Grade II) and three high grade (Grade III) candidiasis, with a frequency of 35%. This rate is higher than the usual spontaneous occurrence rate of esophageal candidiasis, and it is suggested that inhalation of corticosteroid medication can penetrate into the esophagus after deep inhalation. We tested this hypothesis in two studies. 1) To measure the esophageal concentration of FP, four healthy adults inhaled 200 .MU.g FP once. Right after inhalation, FP concentration in the esophageal washing fluid was 3.3 .MU.g. On another day, 30 minutes after the same dose of inhaled FP, one FP concentration in the esophageal washing fluid was 0.67 .MU.g (immediately laydown), and another was 0.11 .MU.g (remained standing). This indicates that even though FP dissipates quickly, it remains in the esophagus 30 minutes after inhalation. 2) We observed the process in one patient with high grade (Grade III) esophageal candidiasis. The time of inhalation was changed from just after getting up and just before going to bed to before breakfast and before dinner. Under this regimen, the signs of esophageal candidiasis improved from high to middle grade. Conclusion:... (author abst.) |
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