Prevalence of Clinical Iatrogenic Cushing’s Syndrome and its Contributing Factors in Patients with Chronic Obstructive Airway Disease

Iatrogenic Cushing’s syndrome develops due to chronic exposure to excess glucocorticoids and is associated with increased morbidity and mortality if it remains unrecognized and untreated. Cushing’s syndrome resulting from long-term use of exogenous glucocorticoids is the commonest cause of iatrogenic Cushing’s syndrome. In India, cases of iatrogenic Cushing’s syndrome are commonly encountered, owing to the steroid abuse for respiratory conditions and chronic pains along with poor access to health care.

This study was conducted in the Department of Respiratory Medicine, Himalayan Institute of Medical Science (HIMS), Swami Ram Nagar, Dehradun. Over a period of 12 months, subjects were recruited from the patients presenting to HIMS, Dehradun” with the primary diagnosis of obstructive airway disease after taking written informed consent.

After a detailed history and examination and applying the inclusion and exclusion criteria, 384 consecutive patients diagnosed with Obstructive airway “disease were enrolled. Demographic data was recorded. Diagnosis of Iatrogenic Cushing syndrome was made on the basis of history of use of glucocorticoids and clinical examination. Most of the patients in the study population were   > 60 years of age (34.29%) There was a male predominance in our study with 243 (63.28%) males and 141 (36.72%) females. Smoking was the major risk factor for COPD in comparison to biomass fuel, present in 85.05% and 15.95%, of patients respectively.

In our study, prevalence of iatrogenic Cushing syndrome in obstructive airway disease was 7.81%. This study highlights role of screening for iatrogenic Cushing syndrome in patients with obstructive airway disease with early intervention to prevent the side effects of chronic indiscriminate use of steroids.