OBJECTIVE: To review the @entity1 profiles, laboratory data, and diagnostic approaches in factitious administration of glucocorticoids. METHODS: Four cases of surreptitious use of glucocorticoids are presented. Clinical and laboratory data as well as imaging studies are summarized. Pertinent case reports in the literature are reviewed. RESULTS: We report four cases of surreptitious use of glucocorticoids encountered within a 2-year period. All four @entity1 were @entity1 without significant @entity146 histories. In three @entity1 , the question of factitious @entity699 was suspected because of physical evidence or symptoms of @entity699 (or both) in the setting of suppressed @entity701 levels. The fourth @entity1 had undetectable @entity701 levels in both serum and 24-hour urine samples but did not have signs or symptoms of @entity1887 . In three cases, the diagnosis was confirmed by direct measurement of synthetic glucocorticoids in the @entity1 's urine or serum. The fourth case was diagnosed by correlating increased @entity701 levels with decreased precursor adrenal @entity230 . CONCLUSIONS: Exogenous corticosteroid use in the absence of a medical indication poses a serious risk to a @entity1 . This possibility should be considered in @entity1 with signs and symptoms consistent with @entity699 but with low serum and urinary @entity701 levels. Similarly, this diagnosis should be suggested in @entity1 without symptoms of @entity1887 and with low @entity701 levels. Laboratory measurement of synthetic @entity230 can be helpful in confirming the diagnosis.

A cluster of cases of factitious XXXX .

@entity1 :: ('9606', 'Species') :: ['women', 'patients', 'patient'] @entity146 :: ('MESH:D001523', 'Disease') :: ['psychiatric'] @entity1887 :: ('MESH:D000309', 'Disease') :: ['adrenal insufficiency'] @entity699 :: ('MESH:D003480', 'Disease') :: ["Cushing's syndrome"] @entity701 :: ('MESH:D006854', 'Chemical') :: ['cortisol'] @entity230 :: ('MESH:D013256', 'Chemical') :: ['steroids']
@entity699 :: (MESH:D003480,Disease) :: ['Cushing's syndrome']
