A child with severe asthma is treated with high-dose inhaled corticosteroids. Which adverse effect is of particular concern?

Inhaled corticosteroids are commonly used to manage conditions like severe asthma due to their potent anti-inflammatory effects. However, long-term or high-dose use of these medications in children raises specific concerns, particularly regarding growth suppression.

Corticosteroids can impact the growth hormone axis and may lead to decreased growth velocity in pediatric patients. Given that children's bodies are still developing, this potential side effect is particularly critical. Monitoring growth in children on high-dose inhaled corticosteroids is essential to ensure that any negative impact on growth is identified and addressed promptly.

While other adverse effects such as Cushing syndrome or hirsutism may occur, they are less commonly associated with inhaled formulations compared to systemic corticosteroids. Hypoglycemia is also not a typical concern linked with inhaled corticosteroids; in fact, systemic side effects often show an opposite effect, such as hyperglycemia. Therefore, among the possible adverse effects of inhaled corticosteroids, growth suppression stands out as a significant concern in pediatric patients.