Clinical adrenal insufficiency in patients receiving megestrol therapy.
OBJECTIVE
To describe the clinical and biochemical features of patients in whom adrenal insufficiency developed during megestrol acetate therapy for advanced breast cancer.


METHODS
Thirteen patients with advanced breast cancer treated with oral megestrol acetate, 160 mg/d.


RESULTS
Fatigue and weakness were observed in all 13 patients. Hypotension was observed in 8. Anorexia, nausea, vomiting, and diarrhea were observed in 3. Mean basal cortisol level at the time of symptoms was 41.4 nmol/L (range, 27.6-110.4 nmol/L). After corticotropin stimulation, mean cortisol level at 30 minutes was 239.2 nmol/L (range, 93.8-447.0 nmol/L); at 60 minutes, 228.2 nmol/L (range, 88.3-474.5 nmol/L).


CONCLUSIONS
Megestrol therapy was associated with the development of clinical adrenal insufficiency in our patients, as proved by rapid corticotropin test.
Subramanian
S
S
Section of Hematology-Oncology, Mercy Hospital and Medical Center, Chicago, Ill, USA.
Goker
H
H
Kanji
A
A
Sweeney
H
H
D000284:Administration, Oral; D000311:Adrenal Glands / Q000187:drug effects* / Q000503:physiopathology*; D000855:Anorexia / Q000139:chemically induced; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000097:blood / Q000188:drug therapy* / Q000473:pathology; D003967:Diarrhea / Q000139:chemically induced; D005221:Fatigue / Q000139:chemically induced; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood*; D007022:Hypotension / Q000139:chemically induced; D019290:Megestrol Acetate / Q000008:administration & dosage / Q000009:adverse effects*; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D016896:Treatment Outcome; D014839:Vomiting / Q000139:chemically induced
D018931:Antineoplastic Agents, Hormonal; D019290:Megestrol Acetate; D006854:Hydrocortisone