She developed SID and hypertension, gained weight and developed a Cushingoid
habitus, which she found particularly distressing.
Iatrogenic percutaneous administration of glucocorticoids is known to cause Cushing's Syndrome (CS) in infants.1,2 Iatrogenic CS caused by the administration of supra-physiologic doses of glucocorticoids is probably much more common (although underreported) than endogenous causes.2,3 It is stated to be the most common cause of CS in children and adolescents.4 Children are at greater risk of toxicity from topical steroids as they have a large surface area compared to adults.5,6 The development of cushingoid
signs and symptoms depends upon the potency and pharmacokinetics of the drug as well as the dose and duration of use.7
appearance Diabetes Diaphoresis Easy bruising Hyperlipidemia Hypertension Increased appetite Impaired wound healing Increased incidence of malignancies Infections Leukopenia Mood lability [Na.sup.+]/ [H.sub.2]O retention Osteoporosis Pancreatitis Peptic ulcers Thrombocytopenia Mycophenolate Orally twice daily.
Oral dosing, unfortunately, causes a spectrum of systemic side effects, including osteoporosis, cushingoid
state, adrenal suppression, and exacerbation of diabetes [12, 13].
On physical exam, the patient presented Cushingoid
features (moon facies, multiple telangiectasias on the face and thorax, skin atrophy, buffalo cervix, centripetal obesity and extended striae on the abdomen and arms, distal muscular atrophy, and peripheral edema) (Figure 1).
-- Diabetes mellitus, osteoporosis, and hypertension are conditions that should boost suspicion that a patient with some cushingoid
features may in fact have endogenous Cushing's syndrome, Dr.
She appeared pale, depressed, cushingoid
, and jaundiced, which was more severe in the sclerae.
In my notes, I had casually described her round face as "mildly cushingoid
," but she certainly didn't view this as a "mild" side effect.
Tum olgularin dordunde deflazakortun ilk uc ayinda "cushingoid
" gorunum saptandi ancak tedavi dozu azaltildikca bu gorunum de kayboldu.
a "linear" increase with increasing dose was found for a Cushingoid
phenotype, ecchymosis, leg edema, parchmentlike skin, and sleep disturbance, and 2.
In contrast, all of the patients who received oral corticosteroids developed cushingoid
features, and 14 developed various steroid-related disorders including gastroesophageal reflux, hypertension, hirsutism, and infections.
Physical examination revealed a well developed, cushingoid
appearing overweight male (BMI = 29) with normal vital signs.