Exogenous Cushing’s Syndrome with Subsequent Secondary Adrenal Insufficiency in Patients with Long Term Steroid Usage

Exogenous Cushing’s syndrome is a collection of symptoms and clinical signs due to elevated levelsof glucocorticoids (cortisol) in the blood because prolonged consumption glucocorticoid drugs.Glucocorticoids were introduced 1950s have been used for anti-inflammatory treatment. Withdrawalof can lead complications secondary adrenal insufficiency caused by suppression ofthe Hypothalamic-Pituitary-Adrenal (HPA) axis. Male, 28 years old, with weakness both hands feetthroughout 3 days before admission hospital. Other complaints include nausea (+), vomiting diarrhea(-). He had taking dexamethasone daily past until one month ago when he suddenlystopped. Physical examination revealed moon facies striae (+) abdomen, motor strength 2in all four extremities. Laboratory: K 2.0 mmol/L, Mg 0.8 mg/dL, GDA 64 Total cholesterol 240 cortisol 18.67 ng/mL, ACTH 2.1 pg/mL. The patient was diagnosed exogenous syndromebased on history long-term use dexamethasone. face, buffalohump, purplish striae, hypertension. stopped suddenly isconsequently experiencing at present time. As evidenced laboratoryvalues, there decrease serum (18.67 ng/mL), as well (2.1 pg/mL). Based use, physical examination, laboratory results, this patienthad syndrome. Sudden discontinuation results withdrawalsymptoms form indicated low values.