title: Megestrol acetate-induced adrenal insufficiency.
abstract: Megestrol acetate is a synthetic progestin that has been used since the 1970s for the treatment of advanced cancer and subsequently to treat anorexia, cachexia and weight loss in AIDS patients. It has been shown that high doses or prolonged treatment with this drug may cause Cushing's syndrome, new-onset diabetes and suppression of plasma ACTH and cortisol levels. Megestrol acetate may cause suppression of the pituitary-adrenal axis due to the affinity of this compound for the glucocorticoid receptor. Recognising the glucocorticoid-like activity of megestrol and its effects at the axis level is important for the diagnosis of sub-clinical adrenal insufficiency. We present the case of a 74-year-old woman with infiltrating ductal breast carcinoma refractory to prolonged hormonal treatment with megestrol acetate, presenting with adrenal insufficiency.
authors.affiliation: Medical Oncology Department, Complejo Hospitalario Universitario de Vigo, Vigo, Spain. Paula.gonzalez.villaroel@sergas.es
authors.forename: Paula
authors.initials: P
authors.lastname: González Villarroel
authors.forename: Isaura
authors.initials: I
authors.lastname: Fernández Pérez
authors.forename: Concepción
authors.initials: C
authors.lastname: Páramo
authors.forename: Marta
authors.initials: M
authors.lastname: Gentil González
authors.forename: Beatriz
authors.initials: B
authors.lastname: Carnero López
authors.forename: M Lidia
authors.initials: ML
authors.lastname: Vázquez Tuñas
authors.forename: Juan A
authors.initials: JA
authors.lastname: Carrasco Alvarez
mesh_terms: D000309:Adrenal Insufficiency / Q000139:chemically induced* / Q000503:physiopathology; D000368:Aged; D018931:Antineoplastic Agents, Hormonal / Q000009:adverse effects*; D001943:Breast Neoplasms / Q000188:drug therapy*; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy*; D005260:Female; D006801:Humans; D019290:Megestrol Acetate / Q000009:adverse effects*; D010490:Pericardial Effusion / Q000209:etiology / Q000601:surgery
chemical_list: D018931:Antineoplastic Agents, Hormonal; D019290:Megestrol Acetate