Etomidate Infusion in the Critical Care Setting for Suppressing the Acute Phase of Cushing's Syndrome

A 17-year-old, 55 kg girl was referred to the endocrinology department of a university hospital to determine the etiology of suspected Cushing's syndrome. The patient was treated with oral ketoconazole for 3 days, but a rapid and severe elevation in her liver function test results led to selection of IV etomidate as a therapeutic option. This approach led to decreasing levels of serum cortisol, and the patient was able to tolerate surgical adrenalectomy.