{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T07:34:56Z","timestamp":1764660896384,"version":"3.43.0"},"reference-count":12,"publisher":"Walter de Gruyter GmbH","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,8,26]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec id=\"j_jpem-2025-0032_abs_001\">\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>Cushing\u2019s syndrome (CS) in children is often caused by prolonged glucocorticoid use. Exogenous steroid administration, mainly oral and parenteral, commonly leads to iatrogenic CS, while topical corticosteroids\u2019 role is less recognized. Here, we present seven pediatric cases of iatrogenic CS linked to topical glucocorticoids, resulting in adrenal insufficiency.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2025-0032_abs_002\">\n                  <jats:title>Case presentation<\/jats:title>\n                  <jats:p>There were seven patients, aged 3\u201360\u00a0months, with diaper dermatitis (six patients) and scabies (one patient), all receiving topical clobetasol propionate for a median duration of 2\u00a0months (range: 0.5\u20133\u00a0months). Adrenal insufficiency was detected in all cases and treated with hydrocortisone at a median dose of 10\u202fmg\/m<jats:sup>2<\/jats:sup>\/day (range: 7.5\u201350\u202fmg\/m<jats:sup>2<\/jats:sup>). One infant also had hypercalcemia. Clinical findings and anthropometric measurements normalized during follow-up, with a median hypothalamic\u2013pituitary\u2013adrenal axis recovery time of 6\u00a0months (range: 4\u20139\u00a0months).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec id=\"j_jpem-2025-0032_abs_003\">\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>This study contributes valuable insights into the management of iatrogenic CS in pediatric patients and emphasizes the need for cautious prescribing practices to safeguard against adverse effects.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1515\/jpem-2025-0032","type":"journal-article","created":{"date-parts":[[2025,4,28]],"date-time":"2025-04-28T15:37:54Z","timestamp":1745854674000},"page":"863-867","source":"Crossref","is-referenced-by-count":3,"title":["Pediatric iatrogenic Cushing\u2019s syndrome: a series of seven cases induced by topical corticosteroid use"],"prefix":"10.1515","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4040-7908","authenticated-orcid":false,"given":"Fatih","family":"Kilci","sequence":"first","affiliation":[{"name":"Department of Pediatric Endocrinology , 668971 Kocaeli City Hospital , Kocaeli , T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7355-5408","authenticated-orcid":false,"given":"Emre","family":"Sar\u0131kaya","sequence":"additional","affiliation":[{"name":"Department of Pediatric Endocrinology , 668971 Kocaeli City Hospital , Kocaeli , T\u00fcrkiye"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"374","published-online":{"date-parts":[[2025,4,28]]},"reference":[{"key":"2025080412565948560_j_jpem-2025-0032_ref_001","doi-asserted-by":"crossref","unstructured":"Lodish, MB, Keil, MF, Stratakis, CA. Cushing\u2019s syndrome in pediatrics: an update. Endocrinol Metab Clin N Am 2018;47:451\u201362. https:\/\/doi.org\/10.1016\/j.ecl.2018.02.008.","DOI":"10.1016\/j.ecl.2018.02.008"},{"key":"2025080412565948560_j_jpem-2025-0032_ref_002","doi-asserted-by":"crossref","unstructured":"Ceccato, F, Scaroni, C. Central adrenal insufficiency: open issues regarding diagnosis and glucocorticoid treatment. Clin Chem Lab Med 2019;57:1125\u201335. https:\/\/doi.org\/10.1515\/cclm-2018-0824.","DOI":"10.1515\/cclm-2018-0824"},{"key":"2025080412565948560_j_jpem-2025-0032_ref_003","doi-asserted-by":"crossref","unstructured":"Ahmed, SM, Ahmed, SF, Othman, S, Abdulla, BA, Mohammed, SH, Salih, AM, et al.. Topical corticosteroid-induced iatrogenic Cushing\u2019s syndrome in an infant; a case report with literature review. Ann Med Surg (Lond). 2021;71:102978. https:\/\/doi.org\/10.1016\/j.amsu.2021.102978.","DOI":"10.1016\/j.amsu.2021.102978"},{"key":"2025080412565948560_j_jpem-2025-0032_ref_004","doi-asserted-by":"crossref","unstructured":"G\u00fcven, A. Different potent glucocorticoids, different routes of exposure but the same result: iatrogenic Cushing\u2019s syndrome and\u00a0adrenal insufficiency. J\u00a0Clin Res Pediatr Endocrinol 2020;12:383\u201392. https:\/\/doi.org\/10.4274\/jcrpe.galenos.2020.2019.0220.","DOI":"10.4274\/jcrpe.galenos.2020.2019.0220"},{"key":"2025080412565948560_j_jpem-2025-0032_ref_005","doi-asserted-by":"crossref","unstructured":"Ozon, A, Cetinkaya, S, Alikasifoglu, A, Gonc, EN, Sen, Y, Kandemir, N. Inappropriate use of potent topical glucocorticoids in infants. J\u00a0Pediatr Endocrinol Metab 2007;20:219\u201325. https:\/\/doi.org\/10.1515\/jpem.2007.20.2.219.","DOI":"10.1515\/JPEM.2007.20.2.219"},{"key":"2025080412565948560_j_jpem-2025-0032_ref_006","doi-asserted-by":"crossref","unstructured":"Wood, HLK, Davallow Ghajar, L, Conaway, M, Rogol, AD. Evaluation of hypothalamic-pituitary-adrenal Axis suppression following cutaneous use of topical corticosteroids in children: a meta-analysis. Horm Res Paediatr 2018;89:389\u201396. https:\/\/doi.org\/10.1159\/000489125.","DOI":"10.1159\/000489125"},{"key":"2025080412565948560_j_jpem-2025-0032_ref_007","doi-asserted-by":"crossref","unstructured":"Siklar, Z, Bostanci, I, Atli, O, Dallar, Y. An infantile Cushing syndrome due to misuse of topical steroid. Pediatr Dermatol 2004;21:561\u20133. https:\/\/doi.org\/10.1111\/j.0736-8046.2004.21508.x.","DOI":"10.1111\/j.0736-8046.2004.21508.x"},{"key":"2025080412565948560_j_jpem-2025-0032_ref_008","doi-asserted-by":"crossref","unstructured":"Alkhuder, L, Mawlawi, H. Infantile iatrogenic cushing syndrome due to topical steroids. Case Rep Pediatr 2019;2019:2652961. https:\/\/doi.org\/10.1155\/2019\/2652961.","DOI":"10.1155\/2019\/2652961"},{"key":"2025080412565948560_j_jpem-2025-0032_ref_009","doi-asserted-by":"crossref","unstructured":"Tempark, T, Phatarakijnirund, V, Chatproedprai, S, Watcharasindhu, S, Supornsilchai, V, Wananukul, S. Exogenous Cushing\u2019s syndrome due to topical corticosteroid application: case report and review literature. Endocrine 2010;38:328\u201334. https:\/\/doi.org\/10.1007\/s12020-010-9393-6.","DOI":"10.1007\/s12020-010-9393-6"},{"key":"2025080412565948560_j_jpem-2025-0032_ref_010","doi-asserted-by":"crossref","unstructured":"G\u00fcven, A, G\u00fcl\u00fcmser, O, Ozgen, T. Cushing\u2019s syndrome and adrenocortical insufficiency caused by topical steroids: misuse or abuse? J\u00a0Pediatr Endocrinol Metab 2007;20:1173\u201382. https:\/\/doi.org\/10.1515\/jpem.2007.20.11.1173.","DOI":"10.1515\/JPEM.2007.20.11.1173"},{"key":"2025080412565948560_j_jpem-2025-0032_ref_011","doi-asserted-by":"crossref","unstructured":"Weintrob, N, Sprecher, E, Josefsberg, Z, Weininger, C, Aurbach-Klipper, Y, Lazard, D, et al.. Standard and low-dose short adrenocorticotropin test compared with insulin-induced hypoglycemia for assessment of the hypothalamic-pituitary-adrenal axis in children with idiopathic multiple pituitary hormone deficiencies. J\u00a0Clin Endocrinol Metab 1998;83:88\u201392. https:\/\/doi.org\/10.1210\/jcem.83.1.4496.","DOI":"10.1210\/jcem.83.1.4496"},{"key":"2025080412565948560_j_jpem-2025-0032_ref_012","doi-asserted-by":"crossref","unstructured":"Muls, E, Bouillon, R, Boelaert, J, Lamberigts, G, Van Imschoot, S, Daneels, R, et al.. Etiology of hypercalcemia in a patient with Addison\u2019s disease. Calcif Tissue Int 1982;34:523\u20136. https:\/\/doi.org\/10.1007\/bf02411297.","DOI":"10.1007\/BF02411297"}],"container-title":["Journal of Pediatric Endocrinology and Metabolism"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpem-2025-0032\/xml","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpem-2025-0032\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,4]],"date-time":"2025-08-04T12:57:39Z","timestamp":1754312259000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.degruyterbrill.com\/document\/doi\/10.1515\/jpem-2025-0032\/html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,28]]},"references-count":12,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2025,8,5]]},"published-print":{"date-parts":[[2025,8,26]]}},"alternative-id":["10.1515\/jpem-2025-0032"],"URL":"https:\/\/doi.org\/10.1515\/jpem-2025-0032","relation":{},"ISSN":["0334-018X","2191-0251"],"issn-type":[{"type":"print","value":"0334-018X"},{"type":"electronic","value":"2191-0251"}],"subject":[],"published":{"date-parts":[[2025,4,28]]}}}