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Less common but sever conditions related to mould spores such as Acute Broncho Pulmonary Aspergillosis (ABPA is a chronic fungal infection plus allergy in the airways) and Extrinsic Allergic Alveolitis (called Farmer’s Lung) should be considered in patients with asthma like symptoms that do not respond to conventional asthma treatments. Occupational (work related) asthma may occur in bread bakers and alsoafter exposure to isocyanates in spray paint, carpentry wood dust, platinum salts in jewellery workers and animal allergens (in veterinary and animal laboratory workers and fish and shellfish factory workers)
Corticosteroid myopathy presents as weakness and wasting of the proximal limb and girdle muscles and is generally reversible following cessation of therapy.
Corticosteroids inhibit intestinal calcium absorption and increase urinary calcium excretion leading to bone resorption and bone loss. Bone loss of 3% over one year has been demonstrated with prednisolone 10 mg per day. Postmenopausal females are particularly at risk for loss of bone density. Sixteen percent of elderly patients treated with corticosteroids for 5 years may experience vertebral compression fractures. One author reported measurable bone loss over two years in women on concomitant therapy with prednisolone mg per day and tamoxifen. [ Ref ]