WYSOLONE-INDUCED IATROGENIC CUSHING’S SYNDROME: A CASE REPORT

Karra Geetha*, Orugala Amulya, B. Shree Bhavana, Satya Jahnavi P., V. Uma Maheshwar Rao

Iatrogenic cushing’s syndrome is a metabolic disorder resulting from prolonged exposure to exogenous glucocorticoids, leading to systemic manifestations such as truncal obesity, moon facies, hypertension, and immunosuppression. We report case of a 44-year-old female with a history of long-term oral prednisolone use for osteoarthritis, who presented with progressive shortness of breath, low-grade fever, facial puffiness, and characteristic cushingoid features including buffalo hump and central obesity. Laboratory evaluation revealed suppressed 8 am serum cortisol and plasma ACTH levels, consistent with hypothalamic-pituitary-adrenal axis suppression. Echocardiography demonstrated preserved ejection fraction, suggesting secondary cardiovascular effects from chronic hypertension. The patient was managed with gradual tapering of corticosteroids, antihypertensive therapy, fluid management, and prophylactic measures against infection. Over the course of treatment, her blood pressure improved, systemic symptoms partially resolved, and biochemical parameters indicated early recovery of adrenal function. This case highlights the potential systemic complications of prolonged corticosteroid therapy and underscores the importance of careful monitoring, timely intervention, and judicious use of steroids to prevent iatrogenic cushing’s syndrome.