title: [Development of Cushing's syndrome during phytotherapy].
abstract: HISTORY AND INITIAL FINDINGS: In a 75-year-old woman with unclear weight gain and typical signs of Cushing's syndrome, a pituitary microadenoma and hyperplasia of the left adrenal gland were diagnosed. She was referred for preoperative diagnostics. Her clinical appearance suggested hypercortisolism.
  
  
  METHODS
  The lab test suggested external glucocorticoid application. Basal ACTH and cortisol were low. DIAGNOSIS, TREATMENT AND FURTHER COURSE: The patients' phytotherapeutics received from a masseuse were analyzed in a special lab. The analysis showed that the pills were enriched with cortisone and hydrocortisone and were causal for the development of Cushing's syndrome and the symptoms of secondary adrenal insufficiency.
  
  
  CONCLUSIONS
  Symptoms of Cushing's syndrome develop during chronic exposure to glucocorticoids. The development of Cushing's syndrome depends on the patient's sensitivity and on the duration and dose of the glucocorticoid application. Clinical and laboratory studies precede imaging.
authors.affiliation: Klinik für Endokrinologie und Diabetologie, Medizinische Fakultät, Heinrich-Heine-Universität Düsseldorf, Düsseldorf, Germany. Christian.Bernecker@web.de
authors.forename: C
authors.initials: C
authors.lastname: Bernecker
authors.forename: B
authors.initials: B
authors.lastname: Hartung
authors.forename: C
authors.initials: C
authors.lastname: Maser-Gluth
authors.forename: M
authors.initials: M
authors.lastname: Schott
authors.forename: H S
authors.initials: HS
authors.lastname: Willenberg
mesh_terms: D000309:Adrenal Insufficiency / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control; D000368:Aged; D003348:Cortisone / Q000009:adverse effects*; D003480:Cushing Syndrome / Q000139:chemically induced* / Q000175:diagnosis / Q000517:prevention & control; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D006854:Hydrocortisone / Q000009:adverse effects*; D008517:Phytotherapy / Q000009:adverse effects*; D010936:Plant Extracts / Q000009:adverse effects* / Q000737:chemistry
chemical_list: D010936:Plant Extracts; D003348:Cortisone; D006854:Hydrocortisone