Ritonavir and Topical Ocular Corticosteroid Induced Cushing's Syndrome in an Adolescent With HIV-1 Infection. Issue 5 (May 2017)

• Record Type: Journal Article
• Authors: Rainsbury, Paul G.; Sharp, Jessica; Tappin, Alison; Hussey, Martin; Lenko, Alexandra; Foster, Caroline
• Is Part Of: Pediatric infectious disease journal. Volume 36:Issue 5(2017)
• Publication Date: 2017-05
• Subjects: HIV -- topical corticosteroids -- eye -- ritonavir -- Cushing's syndrome; Communicable diseases in children -- Periodicals; Infection in children -- Periodicals; 618.929
• DOI: 10.1097/INF.0000000000001534
• Languages: English
• ISSNs: 0891-3668

Abstract

Abstract : Cushing's syndrome after topical ocular corticosteroid use is extremely rare. We describe a case of symptomatic Cushing's syndrome in an adolescent male with sight-threatening vernal keratoconjunctivitis on antiretroviral therapy for HIV-1 infection that included ritonavir, a potent cytochrome p450 CYP3A4 inhibitor. CYP3A4 inhibition reduces the metabolism of exogenous corticosteroids leading to suppression of endogenous steroid production and Cushing's syndrome.