Hdl Handle:
http://hdl.handle.net/10147/209236
Title:
Progestogens and Cushing's syndrome.
Authors:
Harte, C; Henry, M T; Murphy, K D; Mitchell, T H
Affiliation:
Department of Medicine, Cork University Hospital, Wilton.
Citation:
Ir J Med Sci. 1995 Oct-Dec;164(4):274-5.
Journal:
Irish journal of medical science
Issue Date:
3-Feb-2012
URI:
http://hdl.handle.net/10147/209236
PubMed ID:
8522428
Abstract:
We report 3 patients where Medroxyprogesterone Acetate (MPA = Provera) and Megestrol Acetate (Megace) in doses used for therapy of breast cancer, caused clinical hypercortisolism and Cushing's syndrome. Studies of the toxicity of Medroxyprogesterone Acetate list the commonest adverse events at 500 mg/day as weight gain, water retention, increased blood pressure, tremor, moon face, sweating, muscle cramps, vaginal bleeding and increased appetite. Glucocorticoid-like effects are seen in up to 30% of patients treated for longer than 6 weeks with mostly large doses of the order of 1500 mg/day but Cushing's syndrome has been reported in patients taking 400 mg/day. Neither the glucocorticoid-like effects or Cushing's syndrome have been previously observed with Megestrol Acetate. In the elderly female population receiving progestogens for neoplastic disease the progestogen itself could be an appreciable cause of morbidity both by causing glucocorticoid-like effects and Cushing's syndrome but also by lack of awareness of the danger of sudden withdrawal of these compounds when the hypothalmic-pituitary-adrenal (HPA) axis is suppressed. The signs and symptoms could be easily overlooked unless appropriate testing for Cushing's syndrome is carried out. While the progestogen may have to be continued indefinitely a dose decrease may be feasible with reduction of morbidity.
Language:
eng
MeSH:
Adrenocortical Hyperfunction/blood/chemically induced; Aged; Antineoplastic Agents, Hormonal/administration & dosage/*adverse effects; Breast Neoplasms/drug therapy; Cushing Syndrome/blood/*chemically induced; Feasibility Studies; Female; Humans; Hydrocortisone/blood; Medroxyprogesterone Acetate/administration & dosage/*adverse effects; Megestrol/administration & dosage/adverse effects/*analogs & derivatives; Megestrol Acetate; Middle Aged; Muscle Weakness/chemically induced; Progesterone Congeners/administration & dosage/*adverse effects
ISSN:
0021-1265 (Print); 0021-1265 (Linking)

Full metadata record

DC FieldValue Language
dc.contributor.authorHarte, Cen_GB
dc.contributor.authorHenry, M Ten_GB
dc.contributor.authorMurphy, K Den_GB
dc.contributor.authorMitchell, T Hen_GB
dc.date.accessioned2012-02-03T15:15:52Z-
dc.date.available2012-02-03T15:15:52Z-
dc.date.issued2012-02-03T15:15:52Z-
dc.identifier.citationIr J Med Sci. 1995 Oct-Dec;164(4):274-5.en_GB
dc.identifier.issn0021-1265 (Print)en_GB
dc.identifier.issn0021-1265 (Linking)en_GB
dc.identifier.pmid8522428en_GB
dc.identifier.urihttp://hdl.handle.net/10147/209236-
dc.description.abstractWe report 3 patients where Medroxyprogesterone Acetate (MPA = Provera) and Megestrol Acetate (Megace) in doses used for therapy of breast cancer, caused clinical hypercortisolism and Cushing's syndrome. Studies of the toxicity of Medroxyprogesterone Acetate list the commonest adverse events at 500 mg/day as weight gain, water retention, increased blood pressure, tremor, moon face, sweating, muscle cramps, vaginal bleeding and increased appetite. Glucocorticoid-like effects are seen in up to 30% of patients treated for longer than 6 weeks with mostly large doses of the order of 1500 mg/day but Cushing's syndrome has been reported in patients taking 400 mg/day. Neither the glucocorticoid-like effects or Cushing's syndrome have been previously observed with Megestrol Acetate. In the elderly female population receiving progestogens for neoplastic disease the progestogen itself could be an appreciable cause of morbidity both by causing glucocorticoid-like effects and Cushing's syndrome but also by lack of awareness of the danger of sudden withdrawal of these compounds when the hypothalmic-pituitary-adrenal (HPA) axis is suppressed. The signs and symptoms could be easily overlooked unless appropriate testing for Cushing's syndrome is carried out. While the progestogen may have to be continued indefinitely a dose decrease may be feasible with reduction of morbidity.en_GB
dc.language.isoengen_GB
dc.subject.meshAdrenocortical Hyperfunction/blood/chemically induceden_GB
dc.subject.meshAgeden_GB
dc.subject.meshAntineoplastic Agents, Hormonal/administration & dosage/*adverse effectsen_GB
dc.subject.meshBreast Neoplasms/drug therapyen_GB
dc.subject.meshCushing Syndrome/blood/*chemically induceden_GB
dc.subject.meshFeasibility Studiesen_GB
dc.subject.meshFemaleen_GB
dc.subject.meshHumansen_GB
dc.subject.meshHydrocortisone/blooden_GB
dc.subject.meshMedroxyprogesterone Acetate/administration & dosage/*adverse effectsen_GB
dc.subject.meshMegestrol/administration & dosage/adverse effects/*analogs & derivativesen_GB
dc.subject.meshMegestrol Acetateen_GB
dc.subject.meshMiddle Ageden_GB
dc.subject.meshMuscle Weakness/chemically induceden_GB
dc.subject.meshProgesterone Congeners/administration & dosage/*adverse effectsen_GB
dc.titleProgestogens and Cushing's syndrome.en_GB
dc.contributor.departmentDepartment of Medicine, Cork University Hospital, Wilton.en_GB
dc.identifier.journalIrish journal of medical scienceen_GB
dc.description.provinceMunster-

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