Accidental Cushing Syndrome

Author:

Kousoula Konstantina1ORCID,Ragnarsson Oskar123ORCID,Trimpou Penelope12ORCID

Affiliation:

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

2. Department of Internal Medicine and Clinical Nutrition, Institute of Medicine at Sahlgrenska Academy, University of Gothenburg , SE-41345 Gothenburg , Sweden

3. Wallenberg Center for Molecular and Translational Medicine, University of Gothenburg , SE-41345 Gothenburg , Sweden

Abstract

Abstract We present a patient with Cushing syndrome secondary to accidental intake of corticosteroid tablets—a 66-year-old woman with a history of well-controlled hypertension, who over the course of a few weeks developed full-blown Cushing syndrome with uncontrolled blood pressure, typical central fat accumulation, and easy bruising. The clinical features further worsened upon increase of the dosage of her antihypertensive medication because of rising blood pressure. Biochemical analyses showed low cortisol and ACTH concentrations. Inspection of the patient's medications revealed that she had accidentally been taking corticosteroids tablets, prescribed for her husband, instead of antihypertensives, ie, dexamethasone 4 mg and then 8 mg, instead of candesartan at the same dose. This case highlights the necessity of a thorough review of the medications taken by patients suspected to have exogenous Cushing syndrome, including inspection of the original packaging, and not just relying on information from the patient and electronic health records. This case also highlights the need of special labeling on the packaging for the easy identification of corticosteroid-containing medications given their widespread availability.

Publisher

The Endocrine Society

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