: Vogt-Koyanagi-Harada disease (VKH) is a rare autoimmune disorder, especially in children, requiring long-term corticosteroids. We report a 13-year-old male with VKH who developed iatrogenic Cushing's syndrome and secondary adrenal insufficiency after prolonged prednisone treatment. Despite adding mycophenolate mofetil, tapering failed due to relapses. He showed weight gain, growth delay, striae, and suppressed cortisol and adrenocorticotropic hormone, confirming hypothalamic-pituitary-adrenal axis suppression. Hydrocortisone was given for stress coverage. A relapse followed steroid discontinuation. This case highlights the risk of endocrine complications in pediatric VKH and emphasizes the importance of early hormonal evaluation and individualized tapering during chronic steroid therapy.
Secondary Adrenal Insufficiency and Iatrogenic Cushing's Syndrome in a 13-Year-Old Male With Vogt-Koyanagi-Harada Disease: A Case Report / Paparella, Roberto; Bernabei, Irene; Bei, Arianna; Fiorentini, Cinzia; Iafrate, Norma; Lucibello, Roberta; Pastore, Francesca; Pucarelli, Ida; Tarani, Luigi. - In: JOURNAL OF PEDIATRIC HEALTH CARE. - ISSN 0891-5245. - Online ahead of print:(2025). [10.1016/j.pedhc.2025.09.013]
Secondary Adrenal Insufficiency and Iatrogenic Cushing's Syndrome in a 13-Year-Old Male With Vogt-Koyanagi-Harada Disease: A Case Report
Paparella, Roberto;Bernabei, Irene;Bei, Arianna;Fiorentini, Cinzia;Iafrate, Norma;Lucibello, Roberta;Pastore, Francesca;Tarani, Luigi
2025
Abstract
: Vogt-Koyanagi-Harada disease (VKH) is a rare autoimmune disorder, especially in children, requiring long-term corticosteroids. We report a 13-year-old male with VKH who developed iatrogenic Cushing's syndrome and secondary adrenal insufficiency after prolonged prednisone treatment. Despite adding mycophenolate mofetil, tapering failed due to relapses. He showed weight gain, growth delay, striae, and suppressed cortisol and adrenocorticotropic hormone, confirming hypothalamic-pituitary-adrenal axis suppression. Hydrocortisone was given for stress coverage. A relapse followed steroid discontinuation. This case highlights the risk of endocrine complications in pediatric VKH and emphasizes the importance of early hormonal evaluation and individualized tapering during chronic steroid therapy.| File | Dimensione | Formato | |
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