Ayla Güven
Objective: Potent glucocorticoids (GC) cause iatrogenic Cushing’s syndrome (ICS) due to suppression of hypothalamo-pituitary-adrenal (HPA) axis and may progress to adrenal insufficiency (AI). The aim was to review the clinical and laboratory findings of patients with ICS and to investigate other serious side effects. Methods: The possibility of AI was investigated by low-dose adrenocorticotrophic hormone test. Hydrocortisone was started in patients with adrenal failure...
November 25, 2020: Journal of Clinical Research in Pediatric Endocrinology
Soumya Sachdeva, Pooja Arora, Anita Kulhari, Kabir Sardana
Psoriasis vulgaris is a chronic inflammatory disorder that affects the skin and joints. Mild disease is treated with topical corticosteroids (CS) which forms the first line of treatment for localized disease. While it is well established that prolonged use of oral or parenteral corticosteroids can lead to iatrogenic Cushing's Syndrome and suppression of hypothalamic pituitary axis; development of these complications secondary to use of topical CS is rarely described. Since steroids have anti-inflammatory properties, their prolonged use can lead to increased susceptibility to develop bacterial and fungal infections...
May 6, 2020: Dermatologic Therapy
Oliver Taylor, Juan Diego Mejia-Otero, Grace M Tannin, Katherine Gordon
We present a case of iatrogenic Cushing syndrome and adrenal insufficiency in a newborn secondary to an overuse of triamcinolone cream 0.1% prescrived for the treatment of diaper dermatitis.This case highlignts the risks of systemic absorption when prescribing topical medications in the diaper area of an infant, and the importance of caution and proper follow up when prescribing even mid potency steroids to pediatric patients. .
May 2020: Pediatric Dermatology
Lulwah Alkhuder, Horia Mawlawi
Cushing syndrome is an endocrinological disorder characterized by increased free plasma glucocorticoids level. It is either due to an excessive endogenous release of steroids (e.g., pituitary adenoma or adrenal hyperplasia) or exogenous administration of steroids. In children, iatrogenic Cushing syndrome is the most common form of Cushing syndrome occurring in this age group. The vast majority of cases are due to oral or parenteral preparation of steroids, which are commonly prescribed for pulmonary, hematological, renal, or autoimmune pathologies...
2019: Case Reports in Pediatrics
Elisa Monge, Valeria Colombo, Andrea Giacomelli
In this paper we report a case of iatrogenic Cushing syndrome due to a pharmacological interaction between fluticasone and cobicistat. Inhaled corticosteroids were previously thought to be safe, but increasing numbers of cases of iatrogenic Cushing syndrome are being reported, especially in patients taking cytochrome P450 inhibitors, including cobicistat. Although the drug interaction between cobicistat and fluticasone has been described elsewhere, to our knowledge we present one of the first descriptions of iatrogenic Cushing syndrome due to this pharmacological interaction...
December 1, 2019: Le Infezioni in Medicina
Everardo Álvarez-Hernández, Graciela Mercado-Molina, Rosa Consuelo Barrera-Guerra
INTRODUCTION: Currently there are no clinimetric instruments for the measurement of the severity of iatrogenic Cushing's syndrome (ICS). Sonino et al. created a clinical severity index of endogenous Cushing's disease (CSI) but it has not been applied to patients with ICS. OBJECTIVE: To validate and determine the utility of the CSI and its correlation with clinical variables in rheumatological patients with continuous use of glucocorticoids (GC). SUBJECTS AND METHODS: Patients with a history of continuous systemic GC use (for at least 4 weeks) indicated for treatment of rheumatological disease were included...
December 13, 2019: Reumatología Clinica
Sasha O Staack, Allison C Rosenthal, Curtiss B Cook, Ming Yang
An adult lymphoma patient developed Cushing's syndrome following short-term, high-dose dexamethasone administration and presented with distinctive Cushingoid fat redistribution pattern and associated white adipose tissue increased 18 F-FDG uptake. Recognition of the unique 18 F-FDG uptake manifestation may aid in the diagnosis of this iatrogenic syndrome and avoid image misinterpretation.
December 6, 2019: Journal of Nuclear Medicine Technology
Nese Akcan, Nerin N Bahceciler
Asthma is the most common chronic inflammatory disease of children. Inhaled corticosteroids (ICS) are the cornerstone of asthma therapy which are the most effective, commonly used treatment of persistent asthma. Mostly, studies on the relationship between asthma and cortisol have focused on side effects of treatment. Recently, asthmatic patients not treated with ICS have been reported to have an attenuated activity and/or responsiveness of their Hypothalamic-Pituitary- Adrenal (HPA) axis. Moreover, it has been proposed that asthma worsening with stress may be due to a dysfunctional HPA axis, or cortisol insensitivity due to chronic psychological stress through impaired glucocorticoid receptor expression or function...
2020: Current Pediatric Reviews
Maria Socorro Rayas, Andrea Kelly, Kara S Hughan, Tanicia Daley, David Zangen
Cystic fibrosis (CF) is not known to directly affect the adrenal gland, but commonly used CF therapies do impact the function of the hypothalamic-pituitary-adrenal (HPA) axis. By binding to the glucocorticoid receptor, medications such as inhaled and oral corticosteroids can enhance the systemic effects of cortisol and result in iatrogenic Cushing syndrome. Prolonged use suppresses the body's ability to make cortisol, resulting in iatrogenic adrenal insufficiency upon medication discontinuation. Chronic use of inhaled and oral corticosteroids can negatively affect bone health, growth, and glucose metabolism...
October 2019: Journal of Cystic Fibrosis: Official Journal of the European Cystic Fibrosis Society
C Valette, J Ofaiche, M Severino, J Mazereeuw-Hautier
INTRODUCTION: Netherton syndrome (NS) is a rare disease caused by SPINK5 mutations associated with ichthyosis (erythroderma and desquamation), alopecia and atopic manifestations. There are no effective treatments. Topical corticosteroids may be used for a limited period in the event of eczema. Herein we report on a patient with fatal complications related to misuse of topical corticosteroids. PATIENTS AND METHODS: A 38-year-old woman with NS had been using betamethasone for about ten years for severe pruritus...
October 22, 2019: Annales de Dermatologie et de Vénéréologie
Kosei Yamanaka, Masaru Okuda, Takuya Mizuno
BACKGROUND: Glucocorticoids, among the most widely utilized drugs in veterinary medicine, are employed to treat a wide variety of diseases; however, their use often induces adverse events in dogs. The efficacy of glucocorticoids usually depends on dosage, although differences in sensitivity to glucocorticoids in individual animals have been reported. Glucocorticoids bind to the cytoplasmic glucocorticoid receptor (GR), which is expressed in almost all cells. These receptors are key factors in determining individual sensitivity to glucocorticoids...
October 24, 2019: BMC Veterinary Research
Miriam Caffarini, Tatiana Armeni, Pamela Pellegrino, Laura Cianfruglia, Marianna Martino, Annamaria Offidani, Giovanni Di Benedetto, Giorgio Arnaldi, Anna Campanati, Monia Orciani
Cushing syndrome (CS), caused by glucocorticoid (GCs) excess, is strictly connected to onset of different metabolic diseases and impaired wound healing. The source of excessively high levels of GCs allows the identification of endogenous and exogenous (iatrogenic) CS. Iatrogenic patients usually receive also anti-metabolites serving as the foundation to modern steroid-sparing immunosuppressive therapy. Tissues mainly targeted by CS are bone and fat, both derived from progenitor cells named mesenchymal stem cells (MSCs)...
2019: Frontiers in Cell and Developmental Biology
Stefano Piaserico, Dennis Linder, Francesco Messina, Mauro Alaibac
In the present case report, a 32-year-old man with a 20-year long history of psoriasis, who presented with severe lower back pain and had no records of previous trauma, is reported. The patient reported the regular use of clobetasol cream, for 8 years, at an average dosage of 100 grams (g) per week. At the time of visit, the patient presented with severe psoriasis, which was associated with a cushingoid appearance. An X-ray of the spine was performed and the results revealed diffuse vertebral collapse that was caused by osteoporosis...
October 2019: Experimental and Therapeutic Medicine
Solange Edelman, María M Buján, Andrea B Cervinia
Corticosteroids are used in the treatment of many dermatological diseases due to their anti-inflammatory, immunosuppressive and antiproliferative effects. Its indiscriminate use can cause serious local and systemic adverse effects, mainly in children and in the presence of certain predisposing factors. While topical corticosteroids are safe and effective, it is important to pay attention to factors such as patient´s age, skin barrier, clinical characteristic and localization of the lesion, potency and vehicle of the corticosteroid before its prescription to reduce the possibility of adverse effects...
October 1, 2019: Archivos Argentinos de Pediatría
Hartmut P H Neumann, Uliana Tsoy, Irina Bancos, Vincent Amodru, Martin K Walz, Amit Tirosh, Ravinder Jeet Kaur, Travis McKenzie, Xiaoping Qi, Tushar Bandgar, Roman Petrov, Marina Y Yukina, Anna Roslyakova, Anouk N A van der Horst-Schrivers, Annika M A Berends, Ana O Hoff, Luciana Audi Castroneves, Alfonso Massimiliano Ferrara, Silvia Rizzati, Caterina Mian, Sarka Dvorakova, Kornelia Hasse-Lazar, Andrey Kvachenyuk, Mariola Peczkowska, Paola Loli, Feyza Erenler, Tobias Krauss, Madson Q Almeida, Longfei Liu, Feizhou Zhu, Mònica Recasens, Nelson Wohllk, Eleonora P M Corssmit, Zulfiya Shafigullina, Jan Calissendorff, Simona Grozinsky-Glasberg, Tada Kunavisarut, Camilla Schalin-Jäntti, Frederic Castinetti, Petr Vlcek, Dmitry Beltsevich, Viacheslav I Egorov, Francesca Schiavi, Thera P Links, Ronald M Lechan, Birke Bausch, William F Young, Charis Eng
Importance: Large studies investigating long-term outcomes of patients with bilateral pheochromocytomas treated with either total or cortical-sparing adrenalectomies are needed to inform clinical management. Objective: To determine the association of total vs cortical-sparing adrenalectomy with pheochromocytoma-specific mortality, the burden of primary adrenal insufficiency after bilateral adrenalectomy, and the risk of pheochromocytoma recurrence. Design, Setting, and Participants: This cohort study used data from a multicenter consortium-based registry for 625 patients treated for bilateral pheochromocytomas between 1950 and 2018...
August 2, 2019: JAMA network open
Laure Peyro-Saint-Paul, Paul Besnier, Ludivine Demessine, Michel Biour, Dominique Hillaire-Buys, Claire de Canecaude, Sophie Fedrizzi, Jean-Jacques Parienti
OBJECTIVES: To explore the frequent interaction between antiretroviral-boosting agents and corticosteroids causing Cushing's syndrome (CS) in the French Pharmacovigilance Database (FPVD). METHODS: We conducted a retrospective case-control study describing CS recorded in the FPVD between 1996 and 2018. Case was defined as CS occurring in people living with HIV (PLWH) and control was defined as CS in uninfected individuals. Drug-drug interaction (DDI) was defined as an interaction between corticosteroids and CYP3A4 inhibitors...
August 1, 2019: Journal of Antimicrobial Chemotherapy
Vidyadhar R Sardesai, Suyog Shashikant Dhamale, Shibhani S Hegde
No abstract text is available yet for this article.
July 2019: Indian Dermatology Online Journal
Fatma Erden, Murat Borlu, Yasin Simsek, Hasan Fahrettin Kelestemur
Introduction: Cushing's syndrome is a rare condition characterized by increased glucocorticoid levels. Dermatologically, it causes a variety of skin conditions such as atrophy, striae, acne, plethora, hypertrichosis, hirsutism, acanthosis nigricans, hyperpigmentation, alopecia, purpura and fragile skin. Although skin lesions of Cushing's syndrome have been described, exogenous and endogenous types have not been studied in detail. Aim: To determine differences in possible skin lesions depending on the cause of Cushing's syndrome...
June 2019: Postȩpy Dermatologii i Alergologii
Cristina Pijoan Moratalla, Javier Bachiller Corral, Fernando Dronda Núñez
No abstract text is available yet for this article.
December 5, 2018: Journal of Clinical Rheumatology: Practical Reports on Rheumatic & Musculoskeletal Diseases
Guadalupe Estrada-Chávez, Roberto Estrada, Daniel Engelman, Jesus Molina, Guadalupe Chávez-López
The uncontrolled sale of topical corticosteroids has become an important risk factor for the development of iatrogenic Cushing syndrome in children, especially in countries where medications are sold over the counter. This is exacerbated by the lack of information for both the patients and pharmacists. This report documents a series of eight cases of iatrogenic Cushing syndrome secondary to an inappropriate use of topical steroids, due to a misdiagnosis of scabies.
August 3, 2018: Tropical Medicine and Infectious Disease
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