Withdrawal from Glucorticosteroids Therapy: A Role for Tetracosactide 1 mg?

We present the case of a 31-year-old woman who underwent a right surrenectomy for cortical adenoma secreting cortisol responsible of Cushing’s syndrome. After surgery, she was first treated with cortisone acetate 37.5 mg/die and then with hydrocortisone 20 mg/die. Fludrocortisone was administered at the dosage of 0.05 mg/die. Patient complained of severe asthenia and drowsiness and decided to stop therapy. Reduction and subsequent withdrawal from this therapy lasted four months and it took advantage of intramuscular tetracosactide injection. One-year follow-up showed normal values of both basal and stimulated serum cortisol level; the patient was in good physical condition and did not complain any more with asthenia.