RT Journal Article
SR Electronic
T1 Exogenous Cushing's syndrome due to a Chinese herbalist’s prescription of ointment containing dexamethasone
JF BMJ Case Reports
FD BMJ Publishing Group Ltd
SP bcr-2016-218721
DO 10.1136/bcr-2016-218721
VO 2017
A1 Viola Franke
A1 Winnie Francien Scholtens
A1 Ines Alexandra von Rosenstiel
A1 Marie Jose Walenkamp
YR 2017
UL http://casereports.bmj.com/content/2017/bcr-2016-218721.abstract
AB Eczema in children is a chronic disabling condition. The impact of this condition on the lives of families is often underestimated by conventional physicians. As a consequence parents may investigate complementary treatment options. Close monitoring by a paediatrician is essential, considering that a variety of adverse effects can occur during the use of complementary treatment. We present a 5-year-old girl with eczema. She visited a Chinese herbalist who prescribed an ointment. The parents noticed that the eczema resolved fast, itching decreased and she was finally sleeping well. However, her behaviour changed and appetite increased. Undetectable levels of serum cortisol were found, which was indicative of exogenous Cushing's syndrome. Analysis of the ointment revealed the presence of dexamethasone. Hydrocortisone substitution and subsequently a reduction schedule were implemented, after which endogenous cortisol production recovered after 4 months. Physicians should be aware that unregistered herbal medicine can contain potent drugs such as glucocorticoids.