 |
|
Adrenal Crisis in the Setting of High-Dose Ketoconazole Therapy
Sundeep Khosla, MD;
John S. Wolfson, MD, PhD;
Zareh Demerjian, MD;
John E. Godine, MD, PhD
Arch Intern Med. 1989;149(4):802-804.
Abstract
• We describe a patient with type I diabetes mellitus and hypothyroidism who developed frank adrenocortical insufficiency while receiving a high-dose ketoconazole therapy for keratitis caused by Acanthamoeba species. While impaired cortisol responses to corticotropin and mildly symptomatic hypoadrenalism have been described previously with ketoconazole therapy, to our knowledge, this case represents the first documented article of an actual adrenal crisis associated with this drug. Two reasons are postulated for the development of this complication in our patient: high-dose ketoconazole therapy given in divided doses during the day, and a possibly impaired central response to stress because of hypothyroidism. Our article points to the need to monitor patients treated with high-dose ketoconazole for adrenal insufficiency, particularly if associated illnesses are present that may impair an adequate stress response.
(Arch Intern Med. 1989;149:802-804)
Author Affiliations
From the Endocrine, Infectious Disease, and Medical Units, Medical Services, Massachusetts General Hospital, Boston. Dr Khosla is now with the Mayo Clinic, Rochester, Minn.
Footnotes
Accepted for publication December 6,1988.
Reprint requests to Division of Endocrinology, Mayo Clinic, 200 First St SW, Rochester, MN 55905 (Dr Khosla).
 CiteULike  Connotea  Delicious  Digg  Facebook  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
An update on androgen deprivation therapy for prostate cancer
Sharifi et al.
Endocr Relat Cancer 2010;17:R305-R315.
ABSTRACT
| FULL TEXT
Epidemiology of adrenal crisis in chronic adrenal insufficiency: the need for new prevention strategies
Hahner et al.
Eur J Endocrinol 2010;162:597-602.
ABSTRACT
| FULL TEXT
Impact of Fluconazole Prophylaxis on Cortisol Levels in Critically Ill Surgical Patients
Magill et al.
Antimicrob. Agents Chemother. 2004;48:2471-2476.
ABSTRACT
| FULL TEXT
|
