Ugeskr Læger 2016;178:V12150948
Secondary adrenal insufficiency during opiate treatment
A 25-year-old previously healthy man developed secondary adrenal insufficiency during opiate treatment with tramadol and morphine for upper back pain. He experienced a 10 kg weight loss in six weeks. MRI of the hypothalamus and the pituitary gland ruled out cerebral pathology. After discontinuation of the opiate treatment the condition normalised. Opiate therapy can cause endocrine dysfunction, and clinicians should always consider adverse drug reactions as a differential diagnosis for unexplained symptoms.