Megestrol-induced Cushing's syndrome

This case describes the first report of a patient developing Cushing's syndrome whilst being treated with the synthetic progestogen, megestrol acetate (Megace). Drugs are the commonest cause of Cushing's syndrome. Some synthetic progestogens are known to have glucocorticoid activity at high doses. On structural grounds neither megestrol nor its major metabolites would be expected to interact with the glucocorticoid receptor, through the manufacturers report that it may have 'weak glucocorticoid activity'.