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Accidental Cushing Syndrome.

Konstantina Kousoula1, Oskar Ragnarsson1,2,3, Penelope Trimpou1,2

  • 1Department of Endocrinology, Sahlgrenska University Hospital, SE-41345 Gothenburg, Sweden.

JCEM Case Reports
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Summary
This summary is machine-generated.

A woman accidentally took her husband's corticosteroid medication instead of her own, leading to Cushing syndrome. This highlights the importance of verifying all patient medications, including packaging, to prevent serious health issues.

Keywords:
Cushing syndromeaccidental intakedifferential diagnosisexogenous Cushing syndrome

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Area of Science:

  • Endocrinology
  • Pharmacology

Background:

  • Exogenous Cushing syndrome can arise from unintended corticosteroid exposure.
  • Accurate medication reconciliation is crucial for patient safety.

Observation:

  • A 66-year-old woman developed severe Cushing syndrome symptoms, including uncontrolled hypertension and central obesity.
  • Her condition worsened despite increased antihypertensive dosage, due to accidental intake of dexamethasone instead of candesartan.
  • Biochemical tests revealed suppressed cortisol and ACTH levels.

Findings:

  • The patient inadvertently consumed high-dose dexamethasone (4-8 mg daily) for several weeks.
  • Misidentification of medication due to similar packaging led to the accidental corticosteroid intake.
  • This resulted in iatrogenic Cushing syndrome, mimicking endogenous causes.

Implications:

  • Thorough medication review, including physical inspection of original packaging, is essential for diagnosing exogenous Cushing syndrome.
  • Clearer labeling of corticosteroid medications is needed to prevent accidental misuse.
  • Healthcare providers must exercise vigilance in medication reconciliation to avoid potentially severe adverse events.