Secondary adrenal insufficiency due to opiate therapy - another differential diagnosis worth consideration.
We report on a 64-year-old patient in whom fentanyl therapy was found to be responsible for the induction of secondary adrenal insufficiency as clearly demonstrated by re-exposure. We conclude that given the widespread use of opiates in chronic pain management physicians should raise their level of awareness for adrenal insufficiency and look for it generously. Opiates should be added to the list of differential diagnoses to be considered routinely in patients with newly diagnosed secondary adrenal insufficiency.
Division of Endocrinology and Diabetes, Department of Internal Medicine, Kantonsspital St. Gallen, Switzerland. katrin.schimke@kssg.ch
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D000305:Adrenal Cortex Hormones / Q000627:therapeutic use; D000309:Adrenal Insufficiency / Q000139:chemically induced* / Q000175:diagnosis* / Q000188:drug therapy; D000701:Analgesics, Opioid / Q000009:adverse effects; D003937:Diagnosis, Differential; D005283:Fentanyl / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000188:drug therapy
D000305:Adrenal Cortex Hormones; D000701:Analgesics, Opioid; D005283:Fentanyl