Hypercortisolism caused by ritonavir associated inhibition of CYP 3A4 under inhalative glucocorticoid therapy. 2 case reports and a review of the literature

Experimental and Clinical Endocrinology & Diabetes : Official Journal, German Society of Endocrinology [and] German Diabetes Association
C BerneckerH S Willenberg

Abstract

Recent in vitro and in vivo studies have shown a potent inhibition of cytochrome P450 CYP3A4 through human immune deficiency virus (HIV) protease inhibitors (PIs). The PI ritonavir is described as the most potent compound within these CYP3A4 inhibitors. We present 2 cases who developed the sequelae of glucocorticoid excess following ritonavir therapy and inhalative glucocorticoid treatment: A 60-year-old HIV positive man developed the typical symptoms of Cushing's syndrome and a 52-year-old HIV positive man developed severe osteoporosis.

Citations

Jan 30, 2014·Journal of Endocrinological Investigation·R SpiegelC Kasperk
Jan 15, 2014·Endocrine·Annamaria ColaoFelipe F Casanueva
Jun 11, 2014·Enfermedades infecciosas y microbiología clínica·Christian ManzardoJose M Gatell
May 17, 2014·The Lancet. Respiratory Medicine·M Bradley Drummond, Gregory D Kirk
Oct 8, 2016·Orphanet Journal of Rare Diseases·Thierry Brue, Frederic Castinetti

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