Atorvastatin/triamcinolone interaction
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Iatrogenic adrenal insufficiency and Cushing’s syndrome: case report A 48-year-old woman developed iatrogenic adrenal insufficiency and Cushing’s syndrome following concomitant administration of triamcinolone and atorvastatin. The woman had a history of lumbar disc herniation. She presented with hirsutism, nausea and deposition of fat on the back of the neck. One week prior to the presentation, she received two doses of IM triamcinolone [triamcinolone acetate] injection 40mg every other day for pain control due to lumbar disc herniation. She had been receiving treatment with atorvastatin 10 mg/day, concomitantly [route and indication not stated]. Examination at arrival showed moon face appearance, supraclavicular fat deposition and plethorea. Her laboratory examination showed renal cortisol secretion. Therefore, a diagnosis of iatrogenic adrenal insufficiency and Cushing’s syndrome was made. Cortisol level following ACTH stimulation reached to 1.84 mcg/dL, which supported adrenal insufficiency. The woman started receiving hydrocortisone 15 mg/day in divided doses. She was suggested to increase the dose to 20-30 mg/day during a critical illness. At six-month follow-up, her Cushing’s syndrome features disappeared. On 18-month followup, her morning cortisol was still lower, suggestive of ongoing adrenal insufficiency. Torun ANI. Steroid use even for a short time, may not be safe for certain patients. Acta Medica Mediterranea 36: 2901-2902, No. 5, Jan 2020. Available from: URL: http:// 803518284 doi.org/10.19193/0393-6384_2020_5_444
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Reactions 5 Dec 2020 No. 1833
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