Abstract
A 48-year-old woman with HIV infection developed Cushingoid features while she was taking ritonavir-boosted darunavir. Cushing's syndrome was confirmed due to the drug interaction between ritonavir and budesonide. Diagnosis of iatrogenic Cushing's syndrome in HIV-positive patients who are on ritonavir-boosted protease inhibitors (PIs) presents a clinical challenge due to similar clinical features of lipohypertrophy related to ritonavir-boosted PIs. Although this complication has been widely described with the use of inhaled fluticasone, the interaction with inhaled budesonide at therapeutic dose is not widely recognized.
MeSH terms
-
Administration, Inhalation
-
Anti-HIV Agents / administration & dosage
-
Anti-HIV Agents / adverse effects*
-
Anti-HIV Agents / therapeutic use
-
Budesonide / administration & dosage
-
Budesonide / adverse effects*
-
Cushing Syndrome / chemically induced*
-
Cushing Syndrome / complications
-
Drug Interactions
-
Female
-
HIV Infections / complications
-
HIV Infections / drug therapy*
-
Humans
-
Hypothalamo-Hypophyseal System / drug effects
-
Hypothalamo-Hypophyseal System / physiopathology
-
Middle Aged
-
Pituitary-Adrenal System / drug effects
-
Pituitary-Adrenal System / physiopathology
-
Ritonavir / administration & dosage
-
Ritonavir / adverse effects*
-
Ritonavir / therapeutic use
Substances
-
Anti-HIV Agents
-
Budesonide
-
Ritonavir