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CRITICAL CARE AND TRAUMA

Etomidate Infusion in the Critical Care Setting for Suppressing the Acute Phase of Cushing’s Syndrome

Ali Dabbagh, MD^*, Navid Sa’adat, MD, and Zahra Heidari, MD

From the *Department of Anesthesia and Anesthesia Research Center; Department of Endocrinology, Taleghani Hospital and Endocrinology Research Center; and Department of Endocrinology, Taleghani Hospital, Shahid Beheshti University, M.C. Tehran, Iran.

Address correspondence to Ali Dabbagh, MD, Fellowship in Cardiac Anesthesia, Anesthesia Research Center, Shahid Beheshti University, M.C. Tehran, Iran. Address e-mail to alidabbagh{at}yahoo.com.

A 17-year-old, 55 kg girl was referred to the endocrinology department of a university hospital to determine the etiology of suspected Cushing’s syndrome. The patient was treated with oral ketoconazole for 3 days, but a rapid and severe elevation in her liver function test results led to selection of IV etomidate as a therapeutic option. This approach led to decreasing levels of serum cortisol, and the patient was able to tolerate surgical adrenalectomy.