Atypical hypocortisolism

K.M.A. Dreijerink; L.M. Kampschreur; E.G.W.M. Lentjes; B. Lokhorst; P.M.J. Zelissen

doi:10.4158/EP12415.CR

Atypical hypocortisolism

K.M.A. Dreijerink, L.M. Kampschreur, E.G.W.M. Lentjes, B. Lokhorst, P.M.J. Zelissen

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

OBJECTIVE: To report a patient who had developed reversible hypocortisolism during the use of quetiapine.

METHODS: Early morning cortisol levels were measured on two separate days. In addition, the patient underwent testing with intravenous synthetic adrenocorticotropic hormone (1 mcg tetracosactide) before and after tapering of quetiapine. Pituitary function was assessed and magnetic resonance imaging (MRI) was performed.

RESULTS: The patient had low early morning cortisol levels at presentation when using quetiapine. Tetracosactide testing indicated hypocortisolism. A MRI of the pituitary was unremarkable. The patient was treated temporarily with hydrocortisone and quetiapine was tapered. After quetiapine had been discontinued, the patient's cortisol production had returned to normal.

CONCLUSION: Although lowering cortisol levels has been previously reported, this is the first report of hypocortisolism associated with the use of quetiapine. It is possible symptoms of malaise in patients who use quetiapine could be attributed to quetiapine-related hypocortisolism.

Original language	English
Pages (from-to)	e122-e114
Number of pages	3
Journal	Endocrine Practice
Volume	19
Issue number	5
DOIs	https://doi.org/10.4158/EP12415.CR
Publication status	Published - 2013

Keywords

Adult
Antipsychotic Agents/adverse effects
Cosyntropin/pharmacology
Dibenzothiazepines/adverse effects
Humans
Hydrocortisone/blood
Male
Pituitary Gland/drug effects
Quetiapine Fumarate

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10.4158/EP12415.CR

http://www.ncbi.nlm.nih.gov/pubmed/23757611

Cite this

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title = "Atypical hypocortisolism",

abstract = "OBJECTIVE: To report a patient who had developed reversible hypocortisolism during the use of quetiapine.METHODS: Early morning cortisol levels were measured on two separate days. In addition, the patient underwent testing with intravenous synthetic adrenocorticotropic hormone (1 mcg tetracosactide) before and after tapering of quetiapine. Pituitary function was assessed and magnetic resonance imaging (MRI) was performed.RESULTS: The patient had low early morning cortisol levels at presentation when using quetiapine. Tetracosactide testing indicated hypocortisolism. A MRI of the pituitary was unremarkable. The patient was treated temporarily with hydrocortisone and quetiapine was tapered. After quetiapine had been discontinued, the patient's cortisol production had returned to normal.CONCLUSION: Although lowering cortisol levels has been previously reported, this is the first report of hypocortisolism associated with the use of quetiapine. It is possible symptoms of malaise in patients who use quetiapine could be attributed to quetiapine-related hypocortisolism.",

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author = "K.M.A. Dreijerink and L.M. Kampschreur and E.G.W.M. Lentjes and B. Lokhorst and P.M.J. Zelissen",

year = "2013",

doi = "10.4158/EP12415.CR",

language = "English",

volume = "19",

pages = "e122--e114",

journal = "Endocrine Practice",

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T1 - Atypical hypocortisolism

AU - Dreijerink, K.M.A.

AU - Kampschreur, L.M.

AU - Lentjes, E.G.W.M.

AU - Lokhorst, B.

AU - Zelissen, P.M.J.

PY - 2013

Y1 - 2013

N2 - OBJECTIVE: To report a patient who had developed reversible hypocortisolism during the use of quetiapine.METHODS: Early morning cortisol levels were measured on two separate days. In addition, the patient underwent testing with intravenous synthetic adrenocorticotropic hormone (1 mcg tetracosactide) before and after tapering of quetiapine. Pituitary function was assessed and magnetic resonance imaging (MRI) was performed.RESULTS: The patient had low early morning cortisol levels at presentation when using quetiapine. Tetracosactide testing indicated hypocortisolism. A MRI of the pituitary was unremarkable. The patient was treated temporarily with hydrocortisone and quetiapine was tapered. After quetiapine had been discontinued, the patient's cortisol production had returned to normal.CONCLUSION: Although lowering cortisol levels has been previously reported, this is the first report of hypocortisolism associated with the use of quetiapine. It is possible symptoms of malaise in patients who use quetiapine could be attributed to quetiapine-related hypocortisolism.

AB - OBJECTIVE: To report a patient who had developed reversible hypocortisolism during the use of quetiapine.METHODS: Early morning cortisol levels were measured on two separate days. In addition, the patient underwent testing with intravenous synthetic adrenocorticotropic hormone (1 mcg tetracosactide) before and after tapering of quetiapine. Pituitary function was assessed and magnetic resonance imaging (MRI) was performed.RESULTS: The patient had low early morning cortisol levels at presentation when using quetiapine. Tetracosactide testing indicated hypocortisolism. A MRI of the pituitary was unremarkable. The patient was treated temporarily with hydrocortisone and quetiapine was tapered. After quetiapine had been discontinued, the patient's cortisol production had returned to normal.CONCLUSION: Although lowering cortisol levels has been previously reported, this is the first report of hypocortisolism associated with the use of quetiapine. It is possible symptoms of malaise in patients who use quetiapine could be attributed to quetiapine-related hypocortisolism.

KW - Adult

KW - Antipsychotic Agents/adverse effects

KW - Cosyntropin/pharmacology

KW - Dibenzothiazepines/adverse effects

KW - Humans

KW - Hydrocortisone/blood

KW - Male

KW - Pituitary Gland/drug effects

KW - Quetiapine Fumarate

U2 - 10.4158/EP12415.CR

DO - 10.4158/EP12415.CR

M3 - Article

C2 - 23757611

SN - 1530-891X

VL - 19

SP - e122-e114

JO - Endocrine Practice

JF - Endocrine Practice

IS - 5

ER -

Atypical hypocortisolism

Abstract

Keywords

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