Impaired dexamethasone resorption in two patients with pseudo-Cushing after bariatric surgery: Implications for immunosuppressive treatment.
corticosteroid resorption
corticosteroids
gastric bypass
pseudo-Cushing
Journal
Clinical obesity
ISSN: 1758-8111
Titre abrégé: Clin Obes
Pays: England
ID NLM: 101560587
Informations de publication
Date de publication:
Oct 2020
Oct 2020
Historique:
received:
25
03
2020
revised:
04
05
2020
accepted:
22
05
2020
pubmed:
14
6
2020
medline:
1
7
2021
entrez:
14
6
2020
Statut:
ppublish
Résumé
Two cases of middle-aged female patients treated by gastric bypass surgery for weight loss presented to our clinic for a follow-up examination 3-6 months after the surgical procedure (a mini gastric bypass and a modified single anastomosis sleeve-ileostomy). In both patients increased ACTH levels and either high serum cortisol or an increased urinary cortisol excretion was apparent and triggered further endocrine testing. Serum cortisol could not be suppressed adequately by 2 and 4 mg dexamethasone in the standardized oral overnight suppression test while midnight salivary cortisol dropped well below the desired cut-off. This led to the hypothesis of an impaired dexamethasone resorption and could be further substantiated by suppression of serum cortisol below the cut-off by an intravenous dexamethasone application. The data presented point to an impairment of enteral synthetic corticosteroid resorption in patients after gastric bypass surgery and could be of importance for individuals in need for immunosuppressive treatment. In view of the growing number of bariatric procedures, pharmacokinetics of corticosteroids and other drugs should be tested in clinical trials.
Substances chimiques
Dexamethasone
7S5I7G3JQL
Hydrocortisone
WI4X0X7BPJ
Types de publication
Case Reports
Langues
eng
Sous-ensembles de citation
IM
Pagination
e12383Informations de copyright
© 2020 World Obesity Federation.
Références
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