Methyl-Prednisolone and Betamethasone Induced Iatrogenic Cushing Syndrome - A Rare Case Report

Effects of supraphysiologic Glucocorticoid levels originating from exogenous administration of Glucocorticoids known as iatrogenic Cushing syndrome and endogenous overproduction by the adrenal gland (ACTH dependent) or by abnormal adrenocortical tissues (ACTH independent) known as ectopic Cushing syndrome. We report a case of a 50-year-old male patient with symptoms of abdominal distension, swelling of the face, fat deposition around the neck, buffalo hump, and loss of muscles in the upper limbs. The patient had a history of administration of Betamethasone 0.5mg for about 6 months and Methylprednisolone 16mg OD for 15 days. The patient was diagnosed with iatrogenic Cushing syndrome. The steroid dose was tapered gradually to bring back the adrenal function to a normal position. The co-morbid condition leads to the overall worsening of health condition. Therefore, strict control of the co-morbid condition must be a priority. Similar management strategies were adopted by slowly tapering the dose of steroids weekly along with the addition of Furosemide and Metformin to the treatment regimen to control the underlying co-morbid conditions. The case was well managed with appropriate guidelines followed by medication. Identification and diagnosis of this kind of clinical condition are not always clear and consistent. Hence, awareness of diverse forms of presentation of this disorder should be encouraged. Clinical pharmacists have to be aware of these rare syndromes and support the clinicians in whatever ability is required. Far outreach to all healthcare professionals in the form of such case studies can also be an additional tool to create awareness.