Iatrogenic Cushing's Disease Question

[Little Tail Chaser]

Hi all,

Just wondering if someone could please explain the process of iatrogenic hyperadrenocorticism to me? My understanding is that therapeutic glucocorticoids cause atrophy of the adrenals due to the negative feedback loop, downregulation of ACTH etc etc. So why would atrophy result in hyper rather than hypoadrenocorticism?

Apologies for what would probably be a very silly question of my brain wasn't so frazzled from revision! Thank you in advance to anyone who can help! Apologies as well if this is in the wrong place on the forum.

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[Levo]

If you give someone too much corticosteroid, they will have too much corticosteroid. That, and it's side effects, are all Cushing's Syndrome is (not Cushing's Disease, which is specifically caused by a pituitary adenoma and by definition cannot be iatrogenic). Yes, if you then stop the corticosteroid without tapering to give their adrenal axis a chance to wake up again, they will go into adrenal crisis and die.