Iatrogenic Cushing’s syndrome with inhaled steroid plus antidepressant drugs

Çelik, Özlem; Niyazoğlu, Mutlu; Soylu, Hikmet; Kadıoğlu, Pınar

doi:10.1186/2049-6958-7-26

Multidisciplinary Respiratory Medicine

2012

DOI: 10.1186/2049-6958-7-26

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Iatrogenic Cushing’s syndrome with inhaled steroid plus antidepressant drugs

Özlem Çelik

Mutlu Niyazoğlu

Hikmet Soylu

et al.

Abstract: Current guidelines recommend the use of inhaled corticosteroids (ICS) for suppression of airway inflammation in patients with asthma. Although it is well known that ICS cause dose-related adrenocortical suppression, it is less known that they can lead to iatrogenic Cushing’s syndrome (CS). Fluticasone propionate (FP) is an ICS more potent than beclomethasone and budesonide. FP is metabolized as mediated by cytochrome P450 3A4 in the liver and the gut. Systemic bioactivity of FP can increase with the use of dru… Show more

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Cited by 2 publications

References 16 publications

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Prophylactic effectiveness of budesonide inhalation in reducing postoperative throat complaints

Chen

Xiao

2014

Eur Arch Otorhinolaryngol

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Postoperative sore throat (POST) is one of the main postoperative complaints. This study was to evaluate the efficacy of budesonide inhalation suspension (BIS) in reducing the incidence and severity of POST. One hundred and twenty patients scheduled for thyroid surgery with general anesthesia were enrolled and randomized into three groups. Group A received 200 mcg BIS 10 min prior to the tracheal intubation and received the same treatment 6 and 24 h after extubation. Group B received 200 mcg BIS 6 and 24 h after extubation. Control group received the same scheduled treatment as Group A, but the BIS was replaced with 2 ml normal saline. The patients were evaluated for sore throat and hoarseness 1, 24 and 48 h after extubation. The status of laryngopharynx was also recorded. There was no statistically significant difference in the incidence of sore throat among three groups. However, hoarseness occurred significantly less frequently in Group A (P < 0.05). One hour after extubation, Group A exhibited significantly less severe sore throat and hoarseness compared to the other two groups (P < 0.05), which disappeared 24 h later. The mucositis scores of laryngopharynx at 1, 24 and 48 h post-extubation were significantly lower in Group A (P < 0.05). BIS can reduce the incidence and severity of the POST prophylactically.

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Prophylactic effectiveness of budesonide inhalation in reducing postoperative throat complaints

Chen

Xiao

2014

Eur Arch Otorhinolaryngol

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Severe Myocardial Steatosis

Tuzzolo

Febres‐Aldana

Poppiti

2020

Am J Forensic Med Pathol

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Myocardial steatosis, also known as lipomatosis cordis, is characterized by adipose tissue within the myocardium without significant fibrosis. Evidence suggests that accumulation of fat can disturb the normal electromechanical physiology of the myocardium. Herein, we discuss the case of a 60-year-old woman with a history of chronic obstructive pulmonary disease who died because of anoxic encephalopathy after a sudden cardiac arrest (SCA). An electrocardiogram showed QRS fragmentation noted as notched R in inferior leads. The autopsy revealed a very small thromboembolus in a distal subsegmental branch of the pulmonary artery, which could not explain the SCA. There was an extensive intramyocardial accumulation of adipose tissue involving the right ventricle and interventricular septum, which split the myocardium into discrete bundles. Arrhythmogenic right ventricular cardiomyopathy was ruled out based on the absence of typical fibrofatty changes. The mechanism of fat replacement was likely secondary to redistribution of visceral fat in the setting of Cushing syndrome. We propose that severe myocardial steatosis can create an anatomic substrate to facilitate the development of SCA. Myocardial steatosis should be reported to identify patients who are at risk for developing cardiovascular events secondary to extreme cardiac adiposity.

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Iatrogenic Cushing’s syndrome with inhaled steroid plus antidepressant drugs

Cited by 2 publications

References 16 publications

Prophylactic effectiveness of budesonide inhalation in reducing postoperative throat complaints

Prophylactic effectiveness of budesonide inhalation in reducing postoperative throat complaints

Severe Myocardial Steatosis

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