Table of Contents Author Guidelines Submit a Manuscript
Case Reports in Endocrinology
Volume 2013, Article ID 617042, 4 pages
Case Report

Hypothalamic-Pituitary-Adrenal Suppression and Iatrogenic Cushing's Syndrome as a Complication of Epidural Steroid Injections

1Medical Service, VANCHCS, Martinez, CA 94553, USA
2Division of Endocrinology and Metabolism, Department of Internal Medicine, UC Davis School of Medicine, Sacramento, CA 95817, USA

Received 3 June 2013; Accepted 10 July 2013

Academic Editors: G. Aimaretti, C. Capella, O. Isozaki, M. P. Kane, and R. Swaminathan

Copyright © 2013 Joyce Leary and Arthur Swislocki. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Epidural steroid injections are well accepted as a treatment for radicular back pain in appropriate candidates. While overall incidence of systemic side effects has not been well established, at least five biochemically proven cases of iatrogenic Cushing's Syndrome have been reported as complications of epidural steroid treatment. We present an additional case of iatrogenic Cushing's Syndrome and adrenal suppression in a middle-aged woman who received three epidural steroid injections over a four-month period. We review this case in the context of previous cases and discuss diagnostic and management issues.