Secondary Adrenal Insufficiency and Iatrogenic Cushing's Syndrome in a 13-Year-Old Male With Vogt-Koyanagi-Harada Disease: A Case Report
Vogt-Koyanagi-Harada disease (VKH) is a rare autoimmune disorder, especially in children, requiring long-term corticosteroids. We report a 13-year-old male with VKH who developed iatrogenic Cushing's syndrome and secondary adrenal insufficiency after prolonged prednisone treatment. Despite adding mycophenolate mofetil, tapering failed due to relapses. He showed weight gain, growth delay, striae, and suppressed cortisol and adrenocorticotropic hormone, confirming hypothalamic-pituitary-adrenal axis suppression. Hydrocortisone was given for stress coverage. A relapse followed steroid discontinuation. This case highlights the risk of endocrine complications in pediatric VKH and emphasizes the importance of early hormonal evaluation and individualized tapering during chronic steroid therapy.
Authors
- Luigi Tarani (ORCID: https://orcid.org/0000-0001-5958-9364)
- Roberto Paparella (ORCID: https://orcid.org/0000-0001-7020-1471)
- C. Fiorentini (ORCID: https://orcid.org/0009-0003-0857-6039)
- Roberta Lucibello
- Amy K. Bei (ORCID: https://orcid.org/0000-0003-1159-760X)
- F. Pastore (ORCID: https://orcid.org/0000-0001-5962-7826)
- Ida Pucarelli
- Irene Bernabei
- Norma Iafrate
Institutions
- Sapienza University of Rome (IT)
Publication Details
- Journal
- Journal of Pediatric Health Care
- Published
- 2025-10-01
- DOI
- https://doi.org/10.1016/j.pedhc.2025.09.013
- Citations
- 1
- Primary Topic
- Ocular Diseases and Behçet’s Syndrome
- Type
- article
- Field-Weighted Citation Impact
- 1.71