Managing Adrenal Insufficiency in a Pediatric Asthma Patient: A Case of Transition from Inhaled Corticosteroids to Tiotropium Bromide and Ciclesonide

The use of inhaled corticosteroids (ICS) is a cornerstone in the management of asthma, significantly reducing inflammation and improving respiratory function.However, prolonged ICS therapy can lead to systemic side effects, including adrenal insufficiency (AI)[1,2], a condition where the adrenal glands fail to produce adequate levels of cortisol.AI can have serious implications for patient health, especially linear growth, necessitating careful management and alternative therapeutic strategies.