Acute adrenal failure: a potentially fatal consequence of an adulterated herbal remedy.

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Authors
Sensi, Harminder
Buch, Harit
Ford, Loretta
Gama, Rousseau
Issue Date
2019-02
Journal
Type
Case Report
Peer-Reviewed Publication
Keywords
Acute disease
Adrenal insufficiency
Aftercare
Intensive care
Treatment
Outcomes
Drug contamination
Hydrocortisone
Pakistan
Phytotherapy
Endocrinology
Adrenal disorders
Journal Title
BMJ Case Reports
Volume
12
Issue
2
Begin page
e228443
End page
Abstract
Herbal remedies adulterated with glucocorticoids can cause Cushing's syndrome. We report a severe presentation of a 'herbal remedy' adulterated with glucocorticoids; causing a potentially fatal adrenal crisis precipitated by acute illness. Investigations were consistent with adrenal suppression and confirmed, after tablet analysis, to be due to a 'herbal remedy' containing synthetic betamethasone/dexamethasone. This case highlights the need for clinical vigilance and patient education about the potential risks associated with the use of unlicensed treatments and the role of tablet analysis in routine biochemistry.
Citation
Sensi H, Buch H, Ford L, Gama R. Acute adrenal failure: a potentially fatal consequence of an adulterated herbal remedy. BMJ Case Rep. 2019 Feb 19;12(2):e228443. doi: 10.1136/bcr-2018-228443. PMID: 30787026; PMCID: PMC6388792.