TITLE:
Corticosteroid-Induced Adrenal Insufficiency in Africa: Report of Nine Cases at the Internal Medicine/Endocrinology-Diabetology Department of Pikine NHC
AUTHORS:
Nafy Ndiaye, Ngone Diaba Diack, Yakham Mohamed Leye, Abdou Dieng, Mamadou Ba, Abdoulaye Leye
KEYWORDS:
Adrenal Insufficiency, Corticotherapy, Artificial Depigmentation, Self-Medication
JOURNAL NAME:
Open Journal of Endocrine and Metabolic Diseases,
Vol.10 No.12,
December
29,
2020
ABSTRACT:
Introduction: Prolonged corticosteroid therapy is labeled as the main cause of
corticotropic adrenal insufficiency. However, the current frequency of this
complication remains unknown. The objective of our study was to assess its
epidemiologic, diagnostic, therapeutic, and evolutionary aspects of our
practice. Methodology: A 60-month retrospective study was performed from
May 2014 to April 2020 in the Pikine National Hospital Centre. Data were obtained from the medical records of patients with
corticosteroid-induced adrenal insufficiency.
Epidemiologic, diagnostic, therapeutic, and evolutionary parameters, and
data related to corticotherapy were recorded. Patients with basal plasma cortisol levels Results: Medical
records were obtained from nine patients, comprising six women and three men.
The mean age of the patients was 48 years. Long-term corticosteroid therapy was
used for self-medication in six patients and artificial bleaching in the
remaining three patients. Betamethasone was the
most commonly used drug in four patients, followed by clobetasol in three patients. Corticotropic insufficiency was revealed as a result of acute
decompensation in five patients. All patients presented with a
pseudo-cushingoid pattern. Diagnosis of
corticotropic adrenal insufficiency was confirmed by measuring basal plasma cortisol levels of Conclusion: Post-corticosteroid
therapy adrenal insufficiency remains a concern in our practice and is favoured
by the non-compliance of providing rules by pharmacies and the parallel drug
market.