Abstract
Cushing syndrome is a hormonal disorder caused by prolonged exposure of body tissue to cortisol. We report two cases of iatrogenic Cushing's syndrome in two Nigerian children following intranasal administration of aristobed-N (Betamethasone + Neomycin) given at a private hospital where the children presented with feature of adenoidal hypertrophy. Two months into treatment children were noticed to have developed clinical and laboratory features of iatrogenic Cushing's syndrome with critical adrenal suppression. Serum cortisol (at presentation): 1st patient: 12nmol/L (reference range 240-618), 2nd Patient: 1.69nmol/L. Serum cortisol (3 months after weaning off steroid): 343.27 nmol/L (within normal range for the first patient; second patient newly presented and has just begun steroid weaning off process. The serum cortisol level one month into weaninig off process was 128 nmol/L). Unsupervised topical steroid administration in children can cause adrenal suppression with clinical features of Cushing's syndrome.
Highlights
Cushing syndrome is a hormonal disorder caused by prolonged exposure of body tissue to cortisol
We report two children who developed clinical and laboratory features of iatrogenic Cushing's syndrome following unsupervised administration of intranasal steroid
C.W. a 19 month old boy was referred to the Paediatric endocrinology clinic of Lagos University Teaching Hospital with a 2 month history of excessive weight gain and unusual pubic hair growth
Summary
Cushing syndrome is a hormonal disorder caused by prolonged exposure of body tissue to cortisol. Clinical features and markedly reduced serum cortisol & ACTH an assessment of iatrogenic Cushing's syndrome with critical adrenal suppression was made; parents were counseled on need to report to the hospital any time child is sick. (Figure 2) is a 9 month old male infant who presented with 7 week history of excessive weight gain. He has presented 2 months earlier in a private hospital with 3 month history of noisy breathing for which a diagnosis of adenoidal hypertrophy was made and he was given aristobed-N (Betamethasone + Neomycin) 2 drops per nostril tds. One month after commencement of weaning off steroid, the serum cortisol rose to 128nmol/L; bone age was compatible with child's age
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