Document Detail


Decompensated septic shock in the setting of megace-induced severe adrenal suppression in an otherwise healthy pediatric patient: a case report.
MedLine Citation:
PMID:  22863821     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
ABSTRACT: A previously healthy 4-year-old boy presented to the emergency department at the Children's Hospital of Alabama with pneumonia caused by Pneumococcus infection and rapid progression to circulatory collapse. He was described as previously healthy except for being a "picky eater" and has been taking Megace (megestrol acetate) as an appetite stimulant for the past 2 years. We believe that the severity of his presentation was due in part to severe adrenal suppression from long-term Megace use. We were able to successfully resuscitate him with the addition of stress dose hydrocortisone, and he went on to have a complete recovery without any permanent disability. Previous literature has reported the adverse effect of Megace in suppressing adrenal function in patients with cancer and acquired immunodeficiency syndrome. This is the first report of this adverse effect in an otherwise healthy child. As the use of Megace becomes more widespread as an appetite stimulant in children, we hope to raise awareness of this important, potentially life-threatening adverse effect among physicians.
Authors:
Jinyue Li; Margaret Winkler
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Pediatric emergency care     Volume:  28     ISSN:  1535-1815     ISO Abbreviation:  Pediatr Emerg Care     Publication Date:  2012 Aug 
Date Detail:
Created Date:  2012-08-06     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8507560     Medline TA:  Pediatr Emerg Care     Country:  United States    
Other Details:
Languages:  eng     Pagination:  802-4     Citation Subset:  IM    
Affiliation:
From the *Department of Emergency Medicine, University of Alabama Birmingham; and †Division of Pediatric Critical Care, Children's Hospital of Alabama, Birmingham, AL.
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