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Suspected case of Cushing's syndrome with history of taking medicines prescribed by a Chinese Medicine Practitioner

     The Department of Health (DH) today (December 31) alerted clients of a registered Chinese medicine practitioner (CMP) Mr Chan Kong-kin (CMP Chan), practicing at G/F, No.25, Leung Tin Village in Tuen Mun, that if they have been supplied with pills coloured in yellow and orange respectively, or a red-white coloured capsule, they should consult health-care professionals for advice as soon as possible as these drugs might contain undeclared Western medicines including Dexamethasone, Diclofenac, Atropine and Chlorpheniramine.

    "The appeal follows DH's investigation into a suspected case of Cushing's syndrome notified by the Hospital Authority (HA) involving a 58-year-old man who patronised CMP Chan for management of low back pain and occasionally of flu symptoms. He was given the aforementioned pills and capsules for treatment of his disease for around six months," a DH spokesman said.

     "The man attended a general out-patient clinic for low back pain on December 13 and was noticed to have features compatible with Cushing's syndrome, including round face and truncal obesity. Cushing's syndrome can be caused by steroid overdose. The patient was referred to a public hospital for investigation on the same day and was discharged on December 14," the spokesman said.

     "Chemical analysis on patient's drug samples by HA showed that western medicines Dexamethasone and Dicolfenac were detected in the red-white capsule. Atropine was found in the yellowish pills and Chlorpheniramine was found in the orange pills," the spokesman added.

     Dexamethasone is a potent steroid. Taking dexamethasone for a long time, especially when in substantial dosage, can cause side effects such as moon face, high blood pressure, high blood sugar, muscle atrophy, peptic ulcer and even osteoporosis. Diclofenac is one kind of the non-steroidal anti-inflammatory drugs (NSAIDs) which is used as painkillers. It is well known that users will have increased risks of developing complications like gastrointestinal ulcers, some of which may be silent until secondary complications like bleeding set in. Atropine is an antispasmodic on intestinal and uterine smooth muscle. It may cause tachycardia and urinary retention. All these drugs require a doctor's prescription and can only be sold in a dispensary, under the supervision of a pharmacist.  As for chlorpheniramine, it is an over-the-counter Western drug commonly used for relieving allergic symptoms.  The most well known side effect is drowsiness.

     "Preliminary investigation revealed that pills and capsule labelled as the above mentioned western drugs were found in the CMP's premises and all had been seized for further investigation.  While the DH's investigation is ongoing, CMP Chan will assist the DH to contact his clients for medical surveillance in the meantime. The DH has not received other reports of related adverse incidents thus far," the spokesman said.

     "On completion of our investigation, the DH will seek advice from the Department of Justice regarding possible contravention of the Pharmacy and Poisons Ordinance (Cap 138) for the illegal sale or possession of Part I poisons and unregistered pharmaceutical products. The maximum penalty for each is $100,000 and two years' imprisonment. Besides, DH will refer this case to the Chinese Medicine Council of Hong Kong for possible disciplinary action", the spokesman remarked.

     Should any person possesses the above-mentioned medicines, he ought to submit it to the Chinese Medicine Division of the DH at 16/F, AIA Kowloon Tower, Landmark East, 100 How Ming Street, Kwun Tong, during office hours for disposal.

Ends/Monday, December 31, 2012
Issued at HKT 20:22


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