Question 1

What is the Meaning of Iatrogenic Cushing's Syndrome?

Accepted Answer

Iatrogenic Cushing's Syndrome describes hypercortisolism from prolonged exogenous glucocorticoid medications. This form is medically induced via therapeutic corticosteroid administration, distinct from endogenous cortisol overproduction. It represents a significant clinical consequence of these potent anti-inflammatory, immunosuppressive agents.

Question 2

What is the Context of Iatrogenic Cushing's Syndrome?

Accepted Answer

This syndrome primarily impacts the endocrine system, specifically the hypothalamic-pituitary-adrenal (HPA) axis. Exogenous glucocorticoids disrupt natural feedback regulating endogenous cortisol. High external steroid levels suppress pituitary ACTH, leading to diminished natural cortisol synthesis and potential adrenal atrophy.

Question 3

What is the Significance of Iatrogenic Cushing's Syndrome?

Accepted Answer

Recognizing iatrogenic Cushing's Syndrome is clinically important due to its common occurrence. Its presence influences patient management, requiring careful medication dosage and duration. Patients often present with physical changes, metabolic disturbances, and increased cardiovascular risk, necessitating precise differentiation for appropriate care.

Question 4

What is the Mechanism of Iatrogenic Cushing's Syndrome?

Accepted Answer

Exogenous glucocorticoids act on cellular glucocorticoid receptors, mimicking and amplifying natural cortisol effects. Elevated synthetic steroid levels exert potent negative feedback on hypothalamus and pituitary, inhibiting CRH and ACTH release. This sustained ACTH suppression reduces adrenal glands' endogenous cortisol, potentially leading to adrenal cortical atrophy.

Question 5

What is the Application of Iatrogenic Cushing's Syndrome?

Accepted Answer

Iatrogenic Cushing's Syndrome frequently manifests in individuals receiving long-term systemic corticosteroid therapy for inflammatory, autoimmune, or post-transplant conditions. Clinicians must balance therapeutic benefits against inducing this syndrome. Management involves gradual steroid dose reduction, if clinically appropriate, to mitigate adverse effects and allow HPA axis recovery.

Question 6

What is the Metric of Iatrogenic Cushing's Syndrome?

Accepted Answer

Diagnosis relies on comprehensive medication history of corticosteroid use and observation of characteristic clinical signs. Biochemical assessment typically shows suppressed plasma ACTH and often low morning serum cortisol, especially after attempts to reduce or withdraw exogenous steroids. History of prolonged exogenous glucocorticoid administration remains the primary diagnostic indicator.

Question 7

What is the Risk of Iatrogenic Cushing's Syndrome?

Accepted Answer

The main risk is adrenal insufficiency or crisis from abrupt exogenous glucocorticoid cessation. Long-term exposure carries significant risks including osteoporosis, diabetes, hypertension, increased infection susceptibility, muscle weakness, skin thinning, and psychiatric disturbances. Proper medical supervision and gradual tapering are vital to minimize complications and facilitate HPA axis recovery.

Iatrogenic Cushing’s Syndrome

Meaning

Context

Significance

Mechanism

Application

Metric

Risk

What Are the Potential Risks of Targeted Hormonal Therapies for Adrenal Support?

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