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A 39-year-old man with HIV-1 infection, treated with a ritonavir-boosted PI, was started on fluticasone\/salmeterol inhaler and intranasal fluticasone, in 2009, in the setting of asthma and allergic rhinitis. In 2013, he presented with 1-year evolution of symptoms suggesting Cushing's syndrome, and was experiencing recurrent falls. A spine CT showed a vertical L3 fracture and thoracolumbar erosions; a bone density scan revealed severe osteoporosis. Hormonal assays were compatible with hypothalamic\u2013pituitary\u2013adrenal axis suppression, and iatrogenic Cushing's syndrome due to ritonavir\u2013fluticasone interaction was considered. Fluticasone was suspended and oral corticosteroid replacement initiated, with a favourable outcome.<\/jats:p>","DOI":"10.1136\/bcr-2015-211080","type":"journal-article","created":{"date-parts":[[2015,10,29]],"date-time":"2015-10-29T12:37:27Z","timestamp":1446122247000},"page":"bcr2015211080","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":6,"title":["Iatrogenic Cushing's syndrome and osteoporosis due to an interaction between fluticasone and ritonavir"],"prefix":"10.1136","volume":"2015","author":[{"given":"Lu\u00edsa","family":"Azevedo","sequence":"first","affiliation":[{"name":"Department of Internal Medicine, Centro Hospitalar Lisboa Central EPE, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hugo","family":"P\u00eago","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Centro Hospitalar Lisboa Central EPE, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Teresa","family":"Souto Moura","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Centro Hospitalar Lisboa Central EPE, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabel","family":"Germano","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, Centro Hospitalar Lisboa Central EPE, Lisboa, Portugal"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2015,10,29]]},"reference":[{"key":"2025082700380476000_2015.oct29_1.bcr2015211080.1","unstructured":"Lundgren JD , Gatell JM , Furrer H , et al . 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