The Cushing syndrome induced by medroxyprogesterone acetate

Article Abstract:

Cushing's syndrome is a condition that usually occurs as a result of chronic excess glucocorticoid activity caused by excessive secretion of the adrenal gland. A case history is described in which Cushing's syndrome was not due to the usual cause but was induced by medroxyprogesterone acetate, a chemotherapeutic medication used for treating cancer. A 28-year old woman was diagnosed with renal adenocarcinoma (cancer of the kidney). Surgery was performed and long-term chemotherapy was administered which included vinblastine and daily doses of medroxyprogesterone acetate (400 mg per day). After seven years the patient had significant weight gain, high blood pressure, facial swelling ('moon face'), irregular menstruation, mood alteration and other symptoms characteristic of Cushing's syndrome. When chemotherapy was discontinued, signs of glucocorticoid withdrawal occurred. After four months, the Cushing's syndrome symptoms began to disappear. During an 18-month follow-up, the patient was free of malignancy and had few symptoms of Cushing's syndrome. It was concluded that these symptoms were induced by medroxyprogesterone acetate treatments. Other previously documented side effects of this drug include high blood pressure, low blood sugar, fluid retention, weight gain, and moon face, which are consistent with glucocorticoid activity. (Consumer Summary produced by Reliance Medical Information, Inc.)

Case studies, Cushing syndrome, Medroxyprogesterone

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Anthracycline-induced cardiotoxicity

Article Abstract:

Anthracycline treatment may pose both short-term and long-term risk of severe heart damage. Anthracyclines are chemotherapy agents used to treat both leukemias and solid tumors. A review of 146 articles in the medical literature revealed that therapeutic doses of anthracyclines damage the heart and that the damage may not become apparent until years later. All of the methods for monitoring for heart damage have drawbacks, chiefly that they do not reveal early signs. Research is underway into several drugs that may protect the heart during anthracycline treatment or treat the problem, but as yet, research is preliminary.

Heart, Anthracyclines

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The Pemberton sign

Article Abstract:

The Pemberton sign suggests the possible presence of a goiter below the collar bone. This type of enlarged thyroid may be difficult to feel. However, the swelling impedes blood flow in that area. Dr. H.S. Pemberton noted in 1946 that with this type of goiter, raising the arms straight over the head further restricted blood flow. This caused the head to flush deep red with a sharp line of demarcation at the neck. Pemberton's sign was used to help diagnose a goiter in a 62-year-old man who had had a neck mass for 25 years.

Diagnosis, Goiter

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