Iatrogenic Cushing’s syndrome associated with treatment of allergic rhinitis

Iatrogenic Cushing’s syndrome (CS) secondary to intranasal steroid use, although rare, poses significant diagnostic challenges—especially in adults. We present the case of a 40-year-old male who developed CS with hypothalamic-pituitary-adrenal (HPA) axis suppression following prolonged misuse of a d...

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Main Authors: Yasser AL-Ghabra, Mohammed Hamdi, Abdulmajeed Yousfan
Format: Article
Language:English
Published: Taylor & Francis Group 2025-12-01
Series:Acta Oto-Laryngologica Case Reports
Subjects:
Online Access:https://www.tandfonline.com/doi/10.1080/23772484.2025.2497534
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author Yasser AL-Ghabra
Mohammed Hamdi
Abdulmajeed Yousfan
author_facet Yasser AL-Ghabra
Mohammed Hamdi
Abdulmajeed Yousfan
author_sort Yasser AL-Ghabra
collection DOAJ
description Iatrogenic Cushing’s syndrome (CS) secondary to intranasal steroid use, although rare, poses significant diagnostic challenges—especially in adults. We present the case of a 40-year-old male who developed CS with hypothalamic-pituitary-adrenal (HPA) axis suppression following prolonged misuse of a dexamethasone nasal spray for allergic rhinitis. His symptoms resolved after discontinuation of the steroid and gradual hydrocortisone tapering. This case underscores the risk of systemic absorption from high-potency steroids such as dexamethasone, even when administered via non-oral routes. While intranasal steroids are considered safe at standard doses, prolonged misuse—particularly of high-potency formulations—may lead to systemic absorption.
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series Acta Oto-Laryngologica Case Reports
spelling doaj-art-15d7cbdc3ab34d19b3d7e2022b30186f2025-08-20T03:13:22ZengTaylor & Francis GroupActa Oto-Laryngologica Case Reports2377-24842025-12-01101687110.1080/23772484.2025.2497534Iatrogenic Cushing’s syndrome associated with treatment of allergic rhinitisYasser AL-Ghabra0Mohammed Hamdi1Abdulmajeed Yousfan2Department of Otorhinolaryngology, Al-Mouwasat University Hospital, Damascus, SyriaDepartment of Otorhinolaryngology, Al-Mouwasat University Hospital, Damascus, SyriaDepartment of Otorhinolaryngology, Al-Mouwasat University Hospital, Damascus, SyriaIatrogenic Cushing’s syndrome (CS) secondary to intranasal steroid use, although rare, poses significant diagnostic challenges—especially in adults. We present the case of a 40-year-old male who developed CS with hypothalamic-pituitary-adrenal (HPA) axis suppression following prolonged misuse of a dexamethasone nasal spray for allergic rhinitis. His symptoms resolved after discontinuation of the steroid and gradual hydrocortisone tapering. This case underscores the risk of systemic absorption from high-potency steroids such as dexamethasone, even when administered via non-oral routes. While intranasal steroids are considered safe at standard doses, prolonged misuse—particularly of high-potency formulations—may lead to systemic absorption.https://www.tandfonline.com/doi/10.1080/23772484.2025.2497534Allergic rhinitisCushing’s syndromeHPA axis suppressioniatrogenicintranasal steroids
spellingShingle Yasser AL-Ghabra
Mohammed Hamdi
Abdulmajeed Yousfan
Iatrogenic Cushing’s syndrome associated with treatment of allergic rhinitis
Acta Oto-Laryngologica Case Reports
Allergic rhinitis
Cushing’s syndrome
HPA axis suppression
iatrogenic
intranasal steroids
title Iatrogenic Cushing’s syndrome associated with treatment of allergic rhinitis
title_full Iatrogenic Cushing’s syndrome associated with treatment of allergic rhinitis
title_fullStr Iatrogenic Cushing’s syndrome associated with treatment of allergic rhinitis
title_full_unstemmed Iatrogenic Cushing’s syndrome associated with treatment of allergic rhinitis
title_short Iatrogenic Cushing’s syndrome associated with treatment of allergic rhinitis
title_sort iatrogenic cushing s syndrome associated with treatment of allergic rhinitis
topic Allergic rhinitis
Cushing’s syndrome
HPA axis suppression
iatrogenic
intranasal steroids
url https://www.tandfonline.com/doi/10.1080/23772484.2025.2497534
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