Iatrogenic Cushing’s Syndrome at the Regional University Hospital Center of Ouahigouya: A Case Report

Introduction: Iatrogenic Cushing’s syndrome encompasses all clinical manifestations induced by chronic exposure to an exogenous excess of glucocorticoids. It is caused by long-term administration of corticosteroids, most often due to failure to adhere to the guidelines for the use of these medications. The clinical manifestations are numerous, some of which are specific. A chronological link between the administration of high doses of corticosteroids and the onset of clinical manifestations is fundamental. Cushing’s syndrome is associated with increased mortality from cardiovascular complications, severe morbidity, and a reduced quality of life. Case Report: This was a 49-year-old male patient admitted to the hospital for evaluation of severe generalized asthenia, diffuse skin depigmentation, and progressive weight gain. The clinical examination revealed signs of protein hypercatabolism, including skin atrophy, vascular fragility, and wide stretch marks; as well as signs of facial-trunk fat redistribution characteristic of android obesity, with a rounded, erythematous face and a “bison hump”. Evidence of prolonged administration of high-dose betamethasone tablets confirmed the drug-induced cause of the Cushing’s syndrome presentation. The 8-hour serum cortisol level was significantly reduced to 3.62 μg/dl, confirming suppression of the adrenocorticotropic axis. The course of the illness was marked by the onset of acute pulmonary edema and death on the 16th day of hospitalization. Conclusion: Iatrogenic Cushing’s syndrome is preventable by adhering to the indications and contraindications for corticosteroids. Hence, there is a need to raise awareness among healthcare providers regarding the importance of increased vigilance when prescribing and dispensing medications, particularly corticosteroids.