Adrenal insufficiency after treatment of nasal polyposis

OBJECTIVE: Assessment of hypothalamic-pituitary-adrenal (HPA) axis after long term and uncontrolled corticosteroid treatment in nasal polyposis. PATIENTS AND METHODS: A short synacthen test was performed in ten patients who received uncontrolled doses of corticosteroids in a population of 128 patients treated for nasal polyposis. RESULTS: Mean yearly dose of oral prednisone administered in short-term treatment varied between 1280 and 7300 mg. Mean daily dose of inhaled beclomethasone varied between zero and 2000 microg. Morning plasmatic cortisol was abnormal in seven the patients before and after the stimulation (respectively 140 nmole/l and 359 nmole/l). DISCUSSION: High and uncontrolled doses of corticosteroids in nasal polyposis affect HPA axis.