Iatrogenic Cushing's Syndrome After Intrapericardial Corticosteroid Therapy
Authors: STEPHEN R. GRUBB
Journal: Annals of Internal Medicine (1981)

Brief Reports1 December 1981Iatrogenic Cushing's Syndrome After Intrapericardial Corticosteroid TherapySTEPHEN R. GRUBB, M.D., LARRY K. CANTLEY, M.D., DOUGLAS L. JONES, M.D., WILLIAM H. CARTER, M.D.STEPHEN R. GRUBB, M.D., LARRY K. CANTLEY, M.D., DOUGLAS L. JONES, M.D., WILLIAM H. CARTER, M.D.Author, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-95-6-706 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptHypothalamic-pituitary-adrenal suppression occurs with oral, parenteral, and topical corticosteroids in excessive doses and frequently is associated with iatrogenic Cushing's syndrome (1-3). This complication has not been reported with intrabursal or intra-articular steroids nor with intrapericardial corticosteroids. Pericardial cavity drainage by subxiphoid catheter placement with instillation of nonabsorbable steroids for intractable uremic pericardial effusions was used initially by Buselmeier and colleagues (4) with few complications. We report a patient with idiopathic pericarditis and tamponade who developed Cushing's syndrome 6 weeks after intrapericardial instillation of triamcinolone acetonide, thus raising concern regarding the safety of this procedure.A 48-year-old woman presented in August...References1. GRABER A, NEY R, NICHOLSON W, ISLAND D, and LIDDLE G. Natural history of pituitary-adrenal recovery following long-term suppression with corticosteroids. J Clin Endocrinol. 1965;25:11-6. CrossrefGoogle Scholar2. AXELROD L. Glucocorticoid therapy. Medicine. 1976;55:39-65. CrossrefMedlineGoogle Scholar3. SCOGGINS R and KLIMAN B. Percutaneous absorption of corticosteroids. N Engl J Med. 1965;273:831-40. CrossrefMedlineGoogle Scholar4. BUSELMEIER T, SIMMONS R, NAJARIAN J, MAUER S, MATAS A, and KJELLSTRAND C. Uremic pericardial effusions: treatment by catheter drainage and local nonabsorbable steroid administration. Nephron. 1976;16:371-80. CrossrefMedlineGoogle Scholar5. FULLER T, KNOCHEL J, BRENNAN J, FETNER C, and WHITE M. Reversal of intractable uremic pericarditis by triamcinolone hexacetonide. Arch Intern Med. 1976;136:979-82. CrossrefMedlineGoogle Scholar6. SKOV P, HANSEN J, and SPENCER E. Uremic pericarditis. Acta Med Scand. 1969;186:421-8. CrossrefMedlineGoogle Scholar7. KWASNIK E, KOSTER J, and LAZARUS J. Conservative management of uremic pericardial effusions. J Thorac Cardiovasc Surg. 1978;76:629-32. CrossrefMedlineGoogle Scholar8. SILVERBERG S, OREOPOULOS D, and WISE D. Pericarditis in patients undergoing long-term hemodialysis and peritoneal dialysis. Am J Med. 1977;63:874-80. CrossrefMedlineGoogle Scholar9. FOX H, YEE J, WEAVER J, DUGAN D, and SAMSON P. Pericardial drainage operations in the management of uremic pericardial effusions. J Thorac Cardiovasc Surg. 1977;73:504-10. CrossrefMedlineGoogle Scholar10. CHANDRARATNA P and ARONOW W. Limitations of surgical methods of pericardial drainage. JAMA. 1979;242:1062-3. CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: STEPHEN R. GRUBB, M.D.; LARRY K. CANTLEY, M.D.; DOUGLAS L. JONES, M.D.; WILLIAM H. CARTER, M.D.Affiliations: West Virginia University Medical Center/ Charleston Division Charleston Area Medical Center Charleston, West Virginia PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byInfluence of Steroid Therapy on the Incidence of Pericarditis and Atrial Fibrillation After Percutaneous Epicardial Mapping and Ablation for Ventricular TachycardiaIntrapericardial Treatment in Pericardial DiseaseIntrapericardial Triamcinolone Administration for Autoreactive PericarditisIntrapericardial triamcinolone for acute pericarditis after electrophysiologic proceduresExperimental Efficacy of Pericardial Instillation of Anti-inflammatory Agents during Percutaneous Epicardial Catheter Ablation to Prevent Postprocedure PericarditisProlonged childhood Cushing's syndrome secondary to intralesional triamcinolone acetonideCushing Syndrome Induced by Serial Occipital Nerve Blocks Containing CorticosteroidsCushing Syndrome Induced by Serial Occipital Nerve Blocks Containing CorticosteroidsIatrogenic Cushing's syndrome due to dexamethasone nasal dropsCorticosteroids and corticotrophins 1 December 1981Volume 95, Issue 6Page: 706-707KeywordsCathetersCorticosteroid therapyPericardiumSafetySteroids ePublished: 1 December 2008 Issue Published: 1 December 1981 PDF downloadLoading ...