1. Using Etomidate in a Two-month-old Infant with Cushing Syndrome due to Adrenocortical Carcinoma
- Author
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Ah Reum Kwon, Junghwan Suh, Yongha Choi, Ho-Seong Kim, and Jo Won Jung
- Subjects
0301 basic medicine ,Metastatic lesions ,Endocrinology, Diabetes and Metabolism ,03 medical and health sciences ,Cushing syndrome ,0302 clinical medicine ,Endocrinology ,Etomidate ,Adrenocortical Carcinoma ,medicine ,Humans ,Adrenocortical carcinoma ,Surgical treatment ,Cushing Syndrome ,Hyperplasia ,Medical treatment ,business.industry ,Infant ,medicine.disease ,Adrenal Cortex Neoplasms ,030104 developmental biology ,Hypercortisolemia ,030220 oncology & carcinogenesis ,Anesthesia ,Pediatrics, Perinatology and Child Health ,Female ,business ,medicine.drug ,Rare disease - Abstract
Cushing syndrome (CS) is a rare disease caused by hypercortisolemia. Although surgical treatment is the first-line treatment in CS, the appropriate medication for the patient’s condition should be selected when medical treatment is needed. Etomidate is an adrenal-blocking drug used to treat CS and the most suitable for severe hypercortisolemia and adrenocortical carcinoma (ACC), due to cardiovascular stability and an anti-tumorigenic effect. However, its use and safe recommended dosage in infants with CS is unreported. Here we describe the case of a 2-month-old girl treated with etomidate for CS caused by ACC. Even though radical mass excision was performed, severe hypercortisolemia persisted, resulting from metastatic lesions in the liver, and medical treatment was considered. The etomidate doses, no bolus dose and infusion rate of 0.03 mg/kg/hour, may be an appropriate dose for severe hypercortisolemia in infants. This case will help determine future treatment strategies for similar cases in infants.
- Published
- 2022
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