Iatrogenic Cushing Syndrome with Adrenal Suppression in Nigerian Children: A Case Series

A bstract Cushing syndrome (CS) is a multi-systemic disorder caused by overproduction of endogenous glucocorticoids or chronic exposure/intake of high doses of exogenous glucocorticoids. In the pediatric age group, intake of exogenous glucocorticoids is the main etiology of iatrogenic CS. We report three cases of iatrogenic CS with adrenal suppression in three female Nigerian adolescents following prolonged intake of oral and parenteral steroids for chronic medical conditions. The medications (prednisolone and dexamethasone) were taken over several months, during which they developed clinical features of CS as well as adrenal suppression, necessitating presentation to our hospital facility. In all cases, biochemical indices were in keeping with CS with adrenal suppression, and treatment with parenteral and oral hydrocortisone at physiologic doses resulted in marked clinical improvement. The patients are currently on follow-up at the Paediatric Endocrinology Clinic of our hospital.