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Monographs of Topical Drugs that Have Caused Contact Allergy/Allergic Contact Dermatitis
Published in Anton C. de Groot, Monographs in Contact Allergy, 2021
From January 1990 to June 2008, in Leuven, Belgium, 315 patients were diagnosed with contact allergy to/allergic contact dermatitis from corticosteroids (CSs) from routine patch testing with a baseline series including tixocortol pivalate, budesonide, hydrocortisone butyrate and prednisone caproate, patch testing with patients’ own CS preparations, and testing those with proven contact allergy to a corticosteroid or strongly suspected of CS allergy later with a series of 66 CSs, including two sex hormones (progesterone and testosterone). 71% of the patients had relevant reactions, but these were not specified. In this group of 315 CS allergic patients, 25 had positive patch tests to fludrocortisone acetate 0.1% alc. (2). It is unknown how many of these reactions were caused by the use of a pharmaceutical product containing fludrocortisone acetate and how many were cross-reactions to other cortico-steroids.
Endocrine hypertension
Published in Philip E. Harris, Pierre-Marc G. Bouloux, Endocrinology in Clinical Practice, 2014
Frances McManus, John M. Connell, Marie Freel
Fludrocortisone acetate (0.1 mg every 6 h) is administered for 4 days, and in addition, the oral sodium intake is maintained at an intake of >200 mmol/day using sodium chloride supplementation. As in all cases, potassium is monitored regularly and supplemented as required. Plasma renin should be suppressed, and failure to suppress the upright (10 a.m.) aldosterone at day 4 to <166 pmol/L (6 ng/dL) on day 4 confirms the diagnosis of PA. To exclude a confounding effect of ACTH stimulation on aldosterone secretion, it is suggested that plasma cortisol measured at 10 a.m. should be lower than the 7 a.m. level. Although the fludrocortisone suppression test is considered by some to be the most sensitive of the confirmatory tests, it has several disadvantages. There is a significant risk of hypokalemia and consequent dysrhythmia; as such, its use should be restricted to centers with expertise and facilities to cope with complications. In light of this, most centers undertake this test as an inpatient, which has cost and resource implications.
The patient with metabolic alkalosis
Published in Acta Clinica Belgica, 2019
Valentine Gillion, Michel Jadoul, Olivier Devuyst, Jean-Michel Pochet
Aldosterone level was low (1.5 ng/dl; N < 14) as was renin activity (3.3 microIU/L; N 3.3–40) suggesting exposure to an exogenous source of mineralorticoid. Indeed, the topical oral solution contained a high concentration of Fludrocortisone acetate (1mg/1mL)