May 12, 1997

Clinical Adrenal Insufficiency in Patients Receiving Megestrol Therapy

Author Affiliations

From the Sections of Hematology-Oncology (Dr Subramanian) and Endocrinology (Dr Sweeney), Department of Medicine (Drs Subramanian and Sweeney), and Radiation Therapy (Dr Kanji), Mercy Hospital and Medical Center, Chicago, Ill, and the Section of Hematology-Oncology, University of Illinois School of Medicine, Chicago (Dr Goker).

Arch Intern Med. 1997;157(9):1008-1011. doi:10.1001/archinte.1997.00440300118010

Objective:  To describe the clinical and biochemical features of patients in whom adrenal insufficiency developed during megestrol acetate therapy for advanced breast cancer.

Patients and Methods:  Thirteen patients with advanced breast cancer treated with oral megestrol acetate, 160 mg/d.

Results:  Fatigue and weakness were observed in all 13 patients. Hypotension was observed in 8. Anorexia, nausea, vomiting, and diarrhea were observed in 3. Mean basal cortisol level at the time of symptoms was 41.4 nmol/L (range, 27.6-110.4 nmol/L). After corticotropin stimulation, mean cortisol level at 30 minutes was 239.2 nmol/L (range, 93.8-447.0 nmol/L); at 60 minutes, 228.2 nmol/L (range, 88.3-474.5 nmol/L).

Conclusion:  Megestrol therapy was associated with the development of clinical adrenal insufficiency in our patients, as proved by rapid corticotropin test.Arch Intern Med. 1997;157:1008-1011