Megestrol-induced Cushing syndrome

OBJECTIVE: To report a case of Cushing syndrome associated with megestrol a cetate therapy in a patient with renal insufficiency. SUMMARY: A 17-year-old boy with renal insufficiency due to unilateral renal agenesis developed Cushing syndrome and worsening of his renal function af ter megestrol acetate therapy. The diagnosis was based on clinical and anal ytical evaluation. DISCUSSION: Megestrol acetate is indicated for the treatment of cachexia as sociated with AIDS and malignancy. Due to its glucocorticoid activity, mege strol use has resulted in the occurrence of Cushing syndrome in both patien t groups. We report the case of a young patient with renal insufficiency du e to unilateral renal agenesis who developed Cushing syndrome two months af ter administration of high-dose (900-mg/d) megestrol acetate for an eating disorder. CONCLUSIONS: The risk of megestrol-induced Cushing syndrome, especially wit h high doses of the medication, should be considered as a possible adverse effect in patients with renal insufficiency.