Megestrol-induced Cushing syndrome.

Objective: To report a case of Cushing syndrome associated with megestrol acetate 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 after megestrol acetate therapy. The diagnosis was based on clinical and analytical evaluation.
Discussion: Megestrol acetate is indicated for the treatment of cachexia associated with AIDS and malignancy. Due to its glucocorticoid activity, megestrol use has resulted in the occurrence of Cushing syndrome in both patient groups. We report the case of a young patient with renal insufficiency due to unilateral renal agenesis who developed Cushing syndrome two months after administration of high-dose (900-mg/d) megestrol acetate for an eating disorder.
Conclusions: The risk of megestrol-induced Cushing syndrome, especially with high doses of the medication, should be considered as a possible adverse effect in patents with renal insufficiency.