Q:

What are the features of iatrogenic Cushing’s syndrome?

0

A 28-year-old lady presents with complaints of fatigue, inability to climb stairs, since the last two years. She is irritable and has bouts of crying and has stopped pursuing her job as a teacher and prefers to stay at home. She has been found to have hyperglycemia requiring treatment for the same time. Most of her complaints started about 2 years ago when she was put on herbal supplements to increase her appetite and body weight. On examination, she is conscious, appears lost in thought, has thin skin on the dorsum of her hand, purple-colored striae on her abdomen and calves measuring around 1 cm in width. She has patches of red bruises on her inner arms. Her waist circumference is 96 cm and blood pressure is 150/90 mm Hg. She has proximal myopathy of both upper and lower limbs. She has no hirsutism or increased pigmentation. A clinical diagnosis of Cushing’s syndrome is made. She is asked to stop her herbal supplements. An 8 am cortisol assay is done which reveals cortisol of <0.1 mg/dL. A diagnosis of exogenous Cushing’s syndrome is made.

What are the features of iatrogenic Cushing’s syndrome?

All Answers

need an explanation for this answer? contact us directly to get an explanation for this answer

Although most clinical manifestations overlap with endogenous Cushing’s syndrome, some features can be strikingly different in iatrogenic Cushing’s syndrome. The classical symptoms of weight gain, obesity, dorsocervical and supraclavicular fat pads, facial plethora, easy bruising; thin skin, striae, myopathy, and muscle weakness (particularly proximal muscles) are seen in both. Poor wound healing and susceptibility to infection is common. Psychological adverse effects like depression and psychosis can be severe. Metabolic complications like hypertension, hyperglycemia and dyslipidemia also occur. Some manifestations of glucocorticoid excess occur relatively quickly. Psychiatric effects, insomnia, and increased appetite can occur within hours. Generally, a cushingoid appearance takes weeks or even months to develop, as does development of osteoporosis.

• All the features of endogenous Cushing’s can be present in iatrogenic Cushing’s syndrome.

• Psychological effects are acute and can be quite severe.

need an explanation for this answer? contact us directly to get an explanation for this answer

total answers (1)

Similar questions


need a help?


find thousands of online teachers now