Bryn J Pape and Philip A Kern
JCEM Case Reports, Volume 1, Issue 6, November 2023, luad132
https://doi.org/10.1210/jcemcr/luad132
Although most patients are transparent regarding steroid use, rare patients use steroids surreptitiously, which can occasionally result in factitious Cushing syndrome or extensive diagnostic testing. We present 2 cases, 1 with factitious Cushing syndrome and the second with surreptitious steroid use resulting in abnormal laboratory results and a complicated clinical picture. Synthetic glucocorticoid urine testing was positive for triamcinolone acetonide and fluticasone propionate in case 1 and triamcinolone acetonide only in case 2, which clarified the diagnosis and minimized additional and potentially invasive testing.
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