Case Reports
doi: 10.25005/2074-0581-2019-21-2-338-342
CLINICAL EXAMPLE OF ITSENKO-CUSHING DRUG SYNDROME

N.A. Inoyatova, N.F. Niyazova, P.A. Davlatova

Department of Endocrinology, Avicenna Tajik State Medical University, Dushanbe, Republic of Tajikistan

The article describes a clinical example of the drug syndrome of Itsenko-Cushing in a patient suffering for 23 years of bronchial asthma and selfreceiving large doses of glucocorticoids. As a result of long-term therapy, this syndrome developed with concomitant complications such as steroid diabetes and glucocorticoid osteoporosis. In the description of this clinical example, special attention is noteworthy that complications developed as a result of therapy were regarded as a separate nosology, in particular, type 2 diabetes mellitus. It is emphasized that many specialists achieve remission simultaneously prescribe two or more glucocorticoid drugs with different duration of action without accounting for the development of the drug syndrome Itsenko-Cushing. In addition, the need for timely prevention of complications in case of inability to cancel glucocorticoid therapy is emphasized.

Keywords: Itsenko-Cushing syndrome, glucocorticoids, glucocorticoid osteoporosis, steroid diabetes.

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References
  1. Bruno O, Juarez-Allen L, Rossi M, Lonqobordi V. In what clinical settings should Cushing’s syndrome be suspected? Medicina (B Aires). 2009;69(6):674-80.
  2. Mustafakulova NI. Oshibki v dianostike i terapii bronkhial’noy astmy [Errors in diagnosis and treatment of bronchial asthma]. Vestnik Avitsenny [Avicenna Bulletin]. 2008;3:68-71.
  3. Andersen FA, Bergfeld WF, Belsito DV, Hill RA, Klaassen CD, Liebler DC, et al. Final amended safety assessment of hydroquinone as used in cosmetics. Int J Toxicol. 2010;29 Suppl4:274S-87. Available from: http://dx.doi. org/10.1177/1091581810385957.
  4. Rostovtseva ON, Malygina LS, Miserbulatova TA, Koloyan SV. Subklinicheskoe techenie tsiklicheskoy bilezni Itsenko-Kushinga [Subclinical course of cyclic disease of Itsenko-Cushing]. Kubanskiy nauchnyy meditsinskiy vestnik. 2015;152(3):146-9.
  5. Akaza I, Yoshimoto T, Tsuchiya K, Hirata Y. Endothelial dysfunction associated with hypercortisolism is reversible in Cushing’s syndrome. Endocr J. 2010;57(3):245-52.
  6. Paolo Bassareo P, Maria Zedda A, Mercuro G. Impairment of arterial compliance in Cushing’ssyndrome. European Endocrinology. 2014;10(2):161- 4. Available from: http://dx.doi.org/10.17925/EE.2014.10/02.161.
  7. Berr CM, Stieq MR, Deutschbein T, Quinkler M, Schmidmaier R, Osswald A, et al. Persistence of myopathy in Cushing’s syndrome: evaluation of the German Cushing’s Registry. Eur J Endocrinol. 2017;176(6):737-46. Available from: http://dx.doi.org/10.1530/EJE-16-0689.
  8. Minetto MA, Botter A, Lanfranco F, Baldi M, Ghigo E, Arvat E. Muscle fiber conduction slowing and decreased levels of circulating muscle proteins after short-term dexamethasone administration in healthy subjects. J Clin Endocrinol Metab. 2010;95(4):1663-71.
  9. Gaibov AD, Sadriev ON, Anvarova ShS, Kamolov AN. Diagnostika i khirurgicheskoe lechenie sindroma Itsenko-Kushinga [Diagnosis and surgical treatment of Itsenko-Cushing syndrome]. Vestnik Avitsenny [Avicenna Bulletin]. 2014;2:18-24.
  10. Hwang JL, Weiss RE. Steroid-induced diabetes: a clinical and molecular approach to understanding and treatment. Diabetes Metab Res Rev. 2014;30(2):96-102. Available from: http://dx.doi.org/10.1002/ dmrr.2486.
  11. Fardet L, Petersen I, Nazareth I. Risk of cardiovascular events in people prescribed glucocorticoids with iatrogenic Cushing’s syndrome: cohort study. BMJ. 2012;345:e4928. Available from: http://dx.doi.org/10.1136/bmj. e4928.

Authors' information:

Inoyatova Nigina Azizovna
, Candidate of Medical Sciences, Associate Professor of the Department of Endocrinology, Avicenna Tajik State Medical University

Niyazova Nargis Fazlikhudoevna
, Candidate of Medical Sciences, Head of the Department of Endocrinology, Avicenna Tajik State Medical University

Davlatova Parvina Abdukodirovna
, Clinical Resident of the Department of Endocrinology, Avicenna Tajik State Medical University

Conflicts of interest: No conflict

Address for correspondence:

Inoyatova Nigina Azizovna
Candidate of Medical Sciences, Associate Professor of the Department of Endocrinology, Avicenna Tajik State Medical University

734003, Republic of Tajikistan, Dushanbe, Rudaki Ave., 139

Tel.: +992 (917) 330330

E-mail: diabet_rda@mail.ru

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