All the patients presenting with cushingoid
features and history of using nappy rash ointment who presented for the first time during the study period were included.
"I've probably missed a lot because I failed to screen people, not recognizing that they had cushingoid
She again appeared mildly cushingoid
the 11th week of treatment, at which time her Hb (13.3 g/dL), Hct (39%), and MCV (92.1 fL) were normal, and her reticulocyte count (3.12%) was slightly elevated, and she was taking only MP 48 mg/d; her early blood sugar was 141 mg, but HbAlc was normal (3.97%) at that time.
Whereas less serious adverse effects (e.g., skin thinning and Cushingoid
appearance) are often of great concern to RA patients, more debilitating serious toxicities, such as vertebral fractures and cataracts, may be initially unrecognized or asymptomatic.
She experienced extreme anxiety, paranoia, agitation, insomnia and behavioural changes, and some associated systemic effects including developing a cushingoid
appearance, alopecia, systemic and ocular hypertension, nausea and hypercholesterolemia.
Chemotherapy can lead to cushingoid
features and immunosuppression.
Caracteristics of the 14 patients with Cushing's syndrome Subject Typical Low-dose High-dose Cushingoid
(1mg) (8/16mg) Features (*) dex-sup test dex-sup test 1 yes NS NS 2 yes NS S 3 yes NS -- 4 yes NS -- 5 yes NS S 6 yes NS NS 7 yes NS NS 8 yes NS S 9 yes NS S 10 yes NS -- 11 yes NS -- 12 yes NS -- 13 yes NS S 14 yes NS S Subject Abdominal MRI/CT Surgery Cure 1 Adrenal adenoma (5x3cm) R.adrenalectomy yes 2 B.
We did not observe ECS secondary to small cell carcinoma of the lung probably because of lack of typical Cushingoid
features, so these would have been missed by treating physicians and/or rapid downhill course prior to referral to our centre.
* Dermatoiogical changes can occur with steroid therapy, including a redistribution of subcutaneous fat causing the cushingoid
appearance of central obesity, hump back, and moon face.
Physical examination revealed a slightly cushingoid
appearance and the patient was incontinent of urine.
Possible complications include fluid and electrolyte imbalance, muscle weakness and a loss of muscle mass, tendon rupture, osteoporosis, vertebral fractures, aseptic necrosis of the humeral and femoral heads, peptic ulcer, impaired wound healing, a cushingoid
state, adrenocortical insufficiency, cataracts, and decreased carbohydrate tolerance.