Montelukast and Churg-Strauss syndrome
- Resource Type
- Authors
- LIPWORTH, B; WILSON, A; HOSKER, H; TUGGEY, J; MEGHJEE, S; WHITE, J
- Source
- Subject
- Pulmonary and Respiratory Medicine
medicine.medical_specialty
business.industry
medicine.disease
Dose-ranging study
Gastroenterology
Metered-dose inhaler
Fluticasone propionate
Bioavailability
Internal medicine
Anesthesia
medicine
Prednisolone
business
Letters to the Editor
Montelukast
medicine.drug
Fluticasone
Asthma
- Language
- English
I read with interest the case report by Tuggey and Hosker where Churg-Strauss syndrome was associated with the use of montelukast in an asthmatic patient in whom there was no recent exposure to oral corticosteroid.1 However, it is worth noting that the patient was using a high dose of inhaled fluticasone propionate (1.5 mg/day) via a large volume spacer prior to the introduction of montelukast. In this respect, a large volume spacer has been shown to double the systemic bioavailability of fluticasone propionate compared with a metered dose inhaler, in terms of its propensity for adrenal suppression.2 In a dose ranging study in asthmatic patients a comparison was made between inhaled fluticasone propionate via a 750 ml large volume spacer (Volumatic) and oral prednisolone.3 Regression analysis showed significant (p