Iatrogenic Cushing's syndrome caused by treatment with traditional herbal medicine, a case report

摘要

Iatrogenic Cushing's syndrome is caused by the administration of exogenous glucocorticoids. The use of exogenous glucocorticoids has been found as an adulterant in many traditional, alternative medicines. In this case report, we describe a patient with iatrogenic Cushing's syndrome due to chronic use of traditional herbal medicine. A 40-year-old man was diagnosed with iatrogenic Cushing's syndrome due to the long-term use of traditional herbal medicine. After that, he progressively was presented with sudden weight gain, moon faces, supraclavicular fat pads, buffalo hump, truncal obesity, purple striae, and hypertension. Initial investigations detected a low morning serum cortisol level and low serum adrenocorticotropin (ACTH). Other hormonal investigations of the hypothalamic-pituitary axis were normal. He was diagnosed as iatrogenic Cushing's syndrome due to long-term use of traditional herbal medicine that suspected to contain steroids. Physicians should be aware the importance of taking a medical history carefully, with special interest to the use of regular, traditional herbal medicine.