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Clinical Adrenal Insufficiency in Patients Receiving Megestrol Therapy
Seshan Subramanian, MD;
Hakan Goker, MD;
Abdulhamid Kanji, MD;
Howard Sweeney, MD
Arch Intern Med. 1997;157(9):1008-1011.
Abstract
Objective
To describe the clinical and biochemical features of patients in whom adrenal insufficiency developed during megestrol acetate therapy for advanced breast cancer.
Patients and Methods
Thirteen patients with advanced breast cancer treated with oral megestrol acetate, 160 mg/d.
Results
Fatigue and weakness were observed in all 13 patients. Hypotension was observed in 8. Anorexia, nausea, vomiting, and diarrhea were observed in 3. Mean basal cortisol level at the time of symptoms was 41.4 nmol/L (range, 27.6-110.4 nmol/L). After corticotropin stimulation, mean cortisol level at 30 minutes was 239.2 nmol/L (range, 93.8-447.0 nmol/L); at 60 minutes, 228.2 nmol/L (range, 88.3-474.5 nmol/L).
Conclusion
Megestrol therapy was associated with the development of clinical adrenal insufficiency in our patients, as proved by rapid corticotropin test.
Arch Intern Med. 1997;157:1008-1011
Author Affiliations
From the Sections of Hematology-Oncology (Dr Subramanian) and Endocrinology (Dr Sweeney), Department of Medicine (Drs Subramanian and Sweeney), and Radiation Therapy (Dr Kanji), Mercy Hospital and Medical Center, Chicago, Ill, and the Section of Hematology-Oncology, University of Illinois School of Medicine, Chicago (Dr Goker).
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