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[Development of Cushing's syndrome during phytotherapy]
C Bernecker1, B Hartung, C Maser-Gluth
1Klinik für Endokrinologie und Diabetologie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany. Christian.Bernecker@web.de
Deutsche Medizinische Wochenschrift (1946)
|August 6, 2013
Summary
A 75-year-old woman developed Cushing's syndrome due to contaminated phytotherapeutics. Analysis revealed cortisone and hydrocortisone, causing hypercortisolism and secondary adrenal insufficiency.
Area of Science:
- Endocrinology
- Pharmacology
Context:
- A 75-year-old woman presented with symptoms suggestive of Cushing's syndrome, including weight gain and signs of hypercortisolism.
- Initial diagnostics revealed a pituitary microadenoma and left adrenal gland hyperplasia, prompting further investigation.
Purpose:
- To investigate the cause of Cushing's syndrome in a patient with atypical presentation.
- To identify the source of exogenous glucocorticoid exposure.
Summary:
- Laboratory tests suggested external glucocorticoid administration, with low basal ACTH and cortisol levels.
- Analysis of the patient's phytotherapeutics, obtained from a masseuse, revealed enrichment with cortisone and hydrocortisone.
- This contamination was identified as the cause of both Cushing's syndrome and secondary adrenal insufficiency.
Impact:
- Highlights the potential for iatrogenic Cushing's syndrome from contaminated supplements.
- Underscores the importance of thorough patient history and supplement analysis in diagnosing endocrine disorders.
- Demonstrates that chronic glucocorticoid exposure, regardless of source, can lead to Cushing's syndrome and adrenal insufficiency.
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