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Inhaled steroids are generally thought to be free of the systemic effects associated with oral use of these substances. However, a report of the case of an eight-year- old girl with asthma suggests that this isn't always true. The girl became cushingoid after using inhaled steroids (triamcinolone acetonide) twice daily (three puffs with each use) for ten months. She developed the classic features of Cushing's syndrome, including obesity, hirsutism, linear growth retardation, poor school performance, and mood swings. Laboratory tests confirmed low morning serum cortisol levels and low 24-hour urinary 17- hydroxycorticosteroid values. (These manifestations have not previously been described with inhaled triamcinolone acetonide therapy.) Cushi…