Emergency and prolonged use of intravenous etomidate to control hypercortisolemia in a patient with Cushing's syndrome and peritonitis

We report the emergency and prolonged use of etomidate to control circulating cortisol levels in a patient with Cushing's syndrome secondary to ectopic ACTH production from a pancreatic islet cell tumor. Duodenal perforation and peritonitis complicated an episode of salmonella septicemia, precl...

Full description

Saved in:
Bibliographic Details
Published in:The journal of clinical endocrinology and metabolism 1998-10, Vol.83 (10), p.3542-3544
Main Authors: DRAKE, W. M, PERRY, L. A, HINDS, C. J, LOWE, D. G, REZNEK, R. H, BESSER, G. M
Format: Article
Language:English
Subjects:
Adenoma, Islet Cell - secretion
Adenoma, Islet Cell - surgery
Adrenocorticotropic Hormone - secretion
Adult
Biological and medical sciences
Cushing Syndrome - blood
Cushing Syndrome - complications
Cushing Syndrome - etiology
Emergency Medical Services
Etomidate - administration & dosage
Etomidate - therapeutic use
Hormones. Endocrine system
Humans
Hydrocortisone - antagonists & inhibitors
Hydrocortisone - blood
Hydrocortisone - therapeutic use
Injections, Intravenous
Male
Medical sciences
Pancreatic Neoplasms - secretion
Pancreatic Neoplasms - surgery
Peritonitis - complications
Pharmacology. Drug treatments
Preoperative Care
Citations: Items that cite this one
Online Access:Get full text
Tags: Add Tag
No Tags, Be the first to tag this record!
Description
Summary:We report the emergency and prolonged use of etomidate to control circulating cortisol levels in a patient with Cushing's syndrome secondary to ectopic ACTH production from a pancreatic islet cell tumor. Duodenal perforation and peritonitis complicated an episode of salmonella septicemia, precluding the use of conventional oral medical adrenolytic therapy. Endogenous cortisol secretion was abolished by parenteral etomidate, allowing serum cortisol levels to be controlled with an iv infusion of hydrocortisone over an 8-week period in intensive care before definitive pancreatic surgery.
ISSN:0021-972X
1945-7197
DOI:10.1210/jc.83.10.3542