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Warning-sign checks

Exogenous Cushing syndrome: when to get help

Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.

  1. 1

    Is any of this happening now?

    Call 911

    Seek emergency help if you may have adrenal insufficiency and develop signs of an adrenal crisis, including:

    • Severe weakness, collapse or fainting
    • Repeated vomiting or inability to keep steroid medicine down
    • Severe abdominal pain with vomiting or diarrhoea
    • Confusion, extreme drowsiness or loss of consciousness
    • Signs of very low blood pressure, such as faintness and cold, clammy skin

    Follow your emergency steroid plan if you have one, but do not delay emergency care.

    Other emergency signs, for anyone
    • Someone who is struggling to breathe, gasping, choking, or cannot get words out
    • Someone who has chest pain, tightness or pressure lasting more than a few minutes
    • Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
    • Someone who is unconscious, or cannot be woken
    • Someone who is bleeding heavily and it will not stop with firm pressure
    • Someone who has had a seizure that will not stop, or does not wake up afterwards
    • Someone who has lips or skin that look pale, blue, grey or blotchy
    • Someone who you believe has taken an overdose or swallowed something poisonous
  2. 2

    Is any of this happening?

    Be seen today

    Get urgent medical advice for fever or signs of infection while using glucocorticoids because steroids can weaken or hide the usual immune response.

    New severe mood changes, hallucinations, marked confusion, sudden vision changes or symptoms of very high blood sugar also need prompt assessment.

  3. 3

    Does any of this apply?

    Book an appointment

    Arrange routine follow-up for gradual weight or facial changes, easy bruising, muscle weakness, irregular periods or slower growth in a child.

    Also request a review if you use several steroid products or need repeated courses or injections.

Every sign above is quoted from the sofidex article on Exogenous Cushing syndrome. If you are not sure, err upward — it is always reasonable to be checked.