What best explains iatrogenic Cushing's syndrome?

• A. The client has an autoimmune problem that causes destruction of the adrenal cortex.
• B. The client has been taking steroid medications for an extended period for another disease process.
• C. The client has a pituitary gland tumor that causes the adrenal glands to produce too much cortisol.
• D. The client has developed an adrenal gland problem for which the health-care provider does not have an explanation.

Answer: (B)

Iatrogenic Cushing's syndrome occurs when a person is exposed to glucocorticoids from medications for an extended period. These steroids mimic the body’s cortisol and produce the same metabolic effects, while their long-term use suppresses the body’s own cortisol production through negative feedback on the hypothalamic-pituitary-adrenal axis. The result is Cushingoid features such as weight gain, moon face, fat pads on the back of the neck, thinning skin, and glucose intolerance, even though the underlying disease is being treated with steroids. The other scenarios describe endogenous problems—destruction of the adrenal cortex causing cortisol deficiency, a pituitary tumor causing excess ACTH and cortisol, or an unexplained adrenal issue—not the external, medication-driven cause of iatrogenic Cushing's.