STEROID USE EVEN FOR A SHORT TIME, MAY NOT BE SAFE FOR CERTAIN PATIENTS

Ayse Nur Izol Torun^* 

Associate professor, Department of Endocrinology, Near East University, Nicosia, CYP-RUS

Introduction: Steroid therapy may be necessary and effective in some clinical situations, aiming to suppress inflammation and overactive immune system. Long term steroid therapy is related with certain life threatening endocrine complications like iatrogenic adrenal insufficiency (AI) and Cushing’s Syndrome (CS). However, short term treatment is rarely reported to cause these problems. Due to these endocrine issues related with steroid therapy, its use should be considered after definition of an exact benefit.  

Case Presentation: We describe a case of iatrogenic CS and AI following two doses of steroid therapy in a short time. Adrenal gland did not recover during long term follow-up. Possible etiological factors which may play role in development of AI in this case are discussed. 

Conclusion: Steroid therapy even with low doses and in short term may not be safe for several patients. Concomitant drug use which may limit steroid clearance increases the risk of endocrine complications including iatrogenic CS and AI. Polymorphism of CYP3A4/5 enzyme limiting steroid clearence is another rare possibility, which may lead to iatrogenic CS and AI. In conclusion, due to its serious endocrine complications the necessity of steroids should always be considered before its use.