Childhood Cushing's syndrome induced by betamethasone nose drops, and repeat prescriptions

It is stated that nasal steroid drops are important in treating ear,
nose, and throat complaints in children. At our clinic we see a lot of
children but hardly use nasal steroid drops in children--at least, not
under the age of 14 years.
Many children suffer from nasal discharge in terms of blockage, enhanced
secretion and snoring while asleep, and consequent effusion of the middle
ear. The most common events leading to these symptoms are enlarged
adenoids and/or enlarged tonsils and occasionally an allergic nasal
hyperreactivity. After a complete examination including inspection of the
epipharynx the first step in these patients is usually a conservative
treatment consisting of decongesting nose drops for two weeks and a
systemic decongestant +/- and antihistaminic for four weeks. The children
are supposed to return after the treatment course for a control
examination. If the symptoms have not improved, an allergy test is
performed. If an antiallergic therapy with a topical and systemic
antihistamine has not improved the state of the patient, and adenoids are
present, we perform an adenoidectomy. Usually this treatment regime works very
well.
Nasal steroids are only used in children with nasal polyps and chronic
sinusitis; both are very uncommon in children under the age of 14.