Etomidate infusion in the critical care setting for suppressing the acute phase of Cushing's syndrome.
A 17-year-old, 55 kg girl was referred to the endocrinology department of a university hospital to determine the etiology of suspected Cushing's syndrome. The patient was treated with oral ketoconazole for 3 days, but a rapid and severe elevation in her liver function test results led to selection of IV etomidate as a therapeutic option. This approach led to decreasing levels of serum cortisol, and the patient was able to tolerate surgical adrenalectomy.
Dabbagh
Ali
A
Department of Anesthesia and Anesthesia Research Center, Shahid Beheshti University, MC Tehran, Iran. alidabbagh@yahoo.co
Sa'adat
Navid
N
Heidari
Zahra
Z
D000208:Acute Disease; D000284:Administration, Oral; D000293:Adolescent; D000315:Adrenalectomy; D003422:Critical Care; D003480:Cushing Syndrome / Q000188:drug therapy* / Q000209:etiology / Q000378:metabolism / Q000601:surgery; D004791:Enzyme Inhibitors / Q000008:administration & dosage*; D005045:Etomidate / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000097:blood / Q000378:metabolism* / Q000652:urine; D007262:Infusions, Intravenous; D007654:Ketoconazole / Q000008:administration & dosage; D013254:Steroid 17-alpha-Hydroxylase / Q000037:antagonists & inhibitors / Q000378:metabolism; D013250:Steroid Hydroxylases / Q000037:antagonists & inhibitors / Q000378:metabolism; D016896:Treatment Outcome
D004791:Enzyme Inhibitors; D013250:Steroid Hydroxylases; D013254:Steroid 17-alpha-Hydroxylase; C074514:steroid 11-alpha-hydroxylase; D007654:Ketoconazole; D006854:Hydrocortisone; D005045:Etomidate