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Published on: September 15, 2017
Megestrol acetate-associated adrenal insufficiency.
Deepti Bulchandani1, Jagdish Nachnani, Alpesh Amin
1Department of Internal Medicine, University of Missouri Kansas City, Kansas City, Missouri 64108, USA. dbulchandani@yahoo.com
The American Journal of Geriatric Pharmacotherapy
|September 9, 2008
Summary
Megestrol acetate (MA) can cause adrenal insufficiency in elderly patients, leading to serious health issues like hypotension. Discontinuation of MA and steroid replacement improved the patient's condition, highlighting the need for clinical awareness.
Area of Science:
- Endocrinology
- Geriatric Medicine
- Pharmacology
Background:
- Megestrol acetate (MA) is frequently prescribed to enhance weight gain in malnourished elderly individuals.
- Adrenal insufficiency is a known adverse effect of MA, though often overlooked in clinical practice.
Observation:
- An 80-year-old woman on MA for appetite stimulation developed worsening dyspnea, hypotension, and failure to thrive.
- Diagnostic tests revealed adrenal insufficiency, indicated by suboptimal cortisol response to cosyntropin stimulation and low adrenocorticotropic hormone levels.
Findings:
- Discontinuation of MA and initiation of steroid replacement therapy led to blood pressure normalization and gradual patient improvement.
- The patient's condition improved significantly, with normalized adrenal function confirmed by repeat testing at follow-up.
Implications:
- This case highlights a probable link between megeostrol acetate use and the development of adrenal insufficiency in the elderly.
- Healthcare providers should maintain a high index of suspicion for adrenal insufficiency in patients receiving MA therapy.
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