Kanda N, Yasuba H, Takahashi T, Mizuhara Y, Yamazaki S, Imada Y, Izumi Y, Kobayashi Y, Yamashita K, Kita H, Tamada T, Chiba T. Prevalence of esophageal candidiasis among patients treated with inhaled fluticasone propionate.
Am J Gastroenterol 2003;
98:2146-8. [PMID:
14572559 DOI:
10.1111/j.1572-0241.2003.07626.x]
[Citation(s) in RCA: 30] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVES
Development of oropharyngeal candidiasis is a frequently reported adverse effect of inhaled corticosteroid use, but the prevalence of esophageal candidiasis is unknown. The aim of this study was to estimate the prevalence of esophageal candidiasis among patients treated with an inhaled corticosteroid, fluticasone propionate.
METHODS
Upper GI endoscopy was performed on 49 patients treated with inhaled fluticasone propionate to examine the prevalence of esophageal candidiasis. Of the patients, 36 had bronchial asthma and 13 had chronic obstructive pulmonary disease. To compare the prevalence with control patients, upper GI endoscopy was performed on 700 consecutive patients without malignancy or immunosuppression.
RESULTS
The prevalence of esophageal candidiasis was 37% among patients treated with inhaled fluticasone propionate, whereas only 0.3% of the control patients had the infection. The prevalence was especially high among patients with diabetes mellitus or those who were treated with a high dose of inhaled fluticasone propionate. Moreover, a reduction in the daily dose of inhaled fluticasone propionate eliminated the infection in four of five patients.
CONCLUSIONS
Esophageal candidiasis is a common complication of inhaled corticosteroid use.
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