Adrenal insufficiency and iatrogenic Cushing's syndrome in an asthmatic patient on inhaled corticosteroids and antidepressants

2019 ◽  
Author(s):  
Jena Mamdani ◽  
Steven Tao ◽  
Sarah Chatharoo
Keyword(s):  
Adrenal Insufficiency ◽  
Cushing’S Syndrome ◽  
Asthmatic Patient ◽  
Inhaled Corticosteroids ◽  
Cushing's Syndrome ◽  
Iatrogenic Cushing’S Syndrome

scholarly journals Iatrogenic Cushing’s syndrome with inhaled steroid plus antidepressant drugs

2012 ◽  
Vol 7 ◽  
Author(s):  
Ozlem Celik ◽  
Mutlu Niyazoglu ◽  
Hikmet Soylu ◽  
Pinar Kadioglu
Keyword(s):  
Cytochrome P450 ◽  
Fluticasone Propionate ◽  
Cushing’S Syndrome ◽  
Inhaled Corticosteroids ◽  
Rapid Development ◽  
Antidepressant Drugs ◽  
Cushing's Syndrome ◽  
Cytochrome P450 3A4 ◽  
Current Guidelines ◽  
Iatrogenic Cushing’S Syndrome

Current guidelines recommend the use of inhaled corticosteroids (ICS) for suppression of airway inflammation in patients with asthma. Although it is well known that ICS cause dose-related adrenocortical suppression, it is less known that they can lead to iatrogenic Cushing’s syndrome (CS). Fluticasone propionate (FP) is an ICS more potent than beclomethasone and budesonide. FP is metabolized as mediated by cytochrome P450 3A4 in the liver and the gut. Systemic bioactivity of FP can increase with the use of drugs that affect the cytochrome P450. Herein, we report the rapid development of iatrogenic CS in a patient receiving paroxetine and mirtazepine for 12 weeks in addition to inhaled FP.

scholarly journals Iatrogenic Cushing’s Syndrome with Subsequent Adrenal Insufficiency in a Patient with Psoriasis Vulgaris Using Topical Steroids

2017 ◽  
Vol 2017 ◽  
pp. 1-3 ◽  
Author(s):  
Suzan Demir Pektas ◽  
Gursoy Dogan ◽  
Nese Cinar
Keyword(s):  
Adrenal Insufficiency ◽  
Cushing’S Syndrome ◽  
Psoriasis Vulgaris ◽  
Topical Steroid ◽  
Cushing's Syndrome ◽  
Chronic Inflammatory Disease ◽  
High Dose ◽  
Topical Steroids ◽  
First Choice ◽  
Iatrogenic Cushing’S Syndrome

Iatrogenic Cushing’s syndrome (ICS) is usually related to prolonged and/or high-dose oral or parenteral steroid use. Psoriasis vulgaris (PV) is chronic inflammatory disease and characterized by periods of attack and remission. Topical steroid (TS) is the first choice of treatment for localized and mild PV. The development of systemic side effects of the steroids is usually not observed after TS application. But the risk of developing ICS still exists. In the literature, there are a few adult cases who developed ICS and subsequent adrenal insufficiency associated with TS. In this article, a male patient with PV developing ICS and secondary adrenal insufficiency after treatment of TS for 12 years is presented.

scholarly journals Too little or too much corticosteroid? Coexisting adrenal insufficiency and Cushing's syndrome from chronic, intermittent use of intranasal betamethasone

2013 ◽  
Vol 2013 ◽  
Author(s):  
Adrienne Dow ◽  
Run Yu ◽  
John Carmichael
Keyword(s):  
Adrenal Insufficiency ◽  
Cushing’S Syndrome ◽  
Cushing's Syndrome ◽  
High Dose ◽  
List Type ◽  
Secondary Adrenal Insufficiency ◽  
Severe Fatigue ◽  
Learning Points ◽  
Endocrinology Clinic ◽  
Iatrogenic Cushing’S Syndrome

Summary To report the puzzling, rare occurrence of coexisting adrenal insufficiency and Cushing's syndrome from chronic, intermittent use of intranasal betamethasone spray. A 62-year-old male was referred to our endocrinology clinic for management of adrenal insufficiency. This previously healthy individual began to experience chronic sinus symptoms in 2007, was treated with multiple ensuing sinus surgeries, and received oral glucocorticoid for 6 months. In the following 5 years, he suffered severe fatigue and was diagnosed with secondary adrenal insufficiency. He could not be weaned from corticosteroid and developed clear cushingoid features. In our clinic, careful inquiry on medications revealed chronic, intermittent use of high-dose intranasal betamethasone since 2008, which was not apparent to his other treating physicians. His cushingoid features significantly improved after holding intranasal betamethasone. Learning points Chronic, intermittent intranasal betamethasone can cause secondary adrenal insufficiency and iatrogenic Cushing's syndrome when used in excess. Topical corticosteroid use should be considered in the differential diagnosis of adrenal insufficiency or Cushing's syndrome.

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