Iatrogenic hyperadrenocorticism and steatohepatitis caused by unapproved medicine.
A 54-year-old man experienced weight gain. He was diagnosed as having hyperglycemia, hypertension and liver damage. Liver biopsy showed steatohepatitis. We initially suspected him as having hyperadrenocorticism. However, both adrenocorticotropic hormone and cortisol levels were low. Later, it was revealed that he took medicine to relieve his gonalgia. His hyperglycemia, hypertension and liver damage improved after he discontinued taking the medicine. An analysis of this medicine showed that it contained desoximetasone, a glucocorticoid compound that had not been approved for medical use in Japan. To adequately diagnose clinical conditions, it is necessary to survey the patient's medicinal history in detail.
Kitahara
Akira
A
Department of Endocrinology, Kitahara Medical Clinic, Hamamatsu, Japan. kitahara-endo@umin.ac.jp
Saga
Kumiko
K
Koide
Shigeki
S
Isobe
Tomoaki
T
Oki
Yutaka
Y
Nakamura
Hirotoshi
H
D000308:Adrenocortical Hyperfunction / Q000139:chemically induced*; D018771:Arthralgia / Q000188:drug therapy; D056486:Chemical and Drug Induced Liver Injury / Q000209:etiology*; D003899:Desoximetasone / Q000009:adverse effects*; D005234:Fatty Liver / Q000139:chemically induced*; D005938:Glucocorticoids / Q000009:adverse effects*; D006801:Humans; D007719:Knee Joint; D008297:Male; D008875:Middle Aged; D012651:Self Medication / Q000009:adverse effects*
D005938:Glucocorticoids; D003899:Desoximetasone