Cushing's Syndrome in Pregnancy Secondary to Adrenocortical Adenoma: A Case Series and Review
ABSTRACT Purpose To present a case series of Cushing's syndrome (CS) during pregnancy caused by adrenocortical adenomas, highlighting clinical features, hormonal assessments and outcomes. Methods We describe five pregnant women with CS, detailing clinical presentations and laboratory findings....
| Main Authors: | , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Wiley
2024-03-01
|
| Series: | Endocrinology, Diabetes & Metabolism |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/edm2.474 |
| _version_ | 1797246666649108480 |
|---|---|
| author | Yan Wang Yufen An Xiaomei Hou Yanan Xu Zhen Li Xin Liu Fumin Zheng Mingze Sun Rendong Han Caixia Lu Jing Li Jun Zhou |
| author_facet | Yan Wang Yufen An Xiaomei Hou Yanan Xu Zhen Li Xin Liu Fumin Zheng Mingze Sun Rendong Han Caixia Lu Jing Li Jun Zhou |
| author_sort | Yan Wang |
| collection | DOAJ |
| description | ABSTRACT Purpose To present a case series of Cushing's syndrome (CS) during pregnancy caused by adrenocortical adenomas, highlighting clinical features, hormonal assessments and outcomes. Methods We describe five pregnant women with CS, detailing clinical presentations and laboratory findings. Results Common clinical features included a full moon face, buffalo back and severe hypertension. Elevated blood cortisol levels with circadian rhythm disruption and suppressed adrenocorticotrophic hormone (ACTH) levels were observed. Imaging revealed unilateral adrenal tumours. Two cases underwent laparoscopic adrenalectomies during the second trimester, while three had postpartum surgery. All required hormone replacement therapy, with postoperative pathological confirmation of adrenocortical adenomas. Conclusion Diagnosis of CS during pregnancy is challenging due to overlapping features with normal pregnancy: elevated blood cortisol levels and abnormal diurnal rhythm of blood cortisol, suppressed aid diagnosis. Treatment should be individualised due to a lack of explicit optimum therapeutic approaches. Laparoscopic adrenalectomy may be an optimal choice, along with multidisciplinary management including hormone replacement therapy. |
| first_indexed | 2024-04-24T19:46:26Z |
| format | Article |
| id | doaj.art-90a1d782d2d14e78b1017fa30deda3a0 |
| institution | Directory Open Access Journal |
| issn | 2398-9238 |
| language | English |
| last_indexed | 2024-04-24T19:46:26Z |
| publishDate | 2024-03-01 |
| publisher | Wiley |
| record_format | Article |
| series | Endocrinology, Diabetes & Metabolism |
| spelling | doaj.art-90a1d782d2d14e78b1017fa30deda3a02024-03-25T06:14:31ZengWileyEndocrinology, Diabetes & Metabolism2398-92382024-03-0172n/an/a10.1002/edm2.474Cushing's Syndrome in Pregnancy Secondary to Adrenocortical Adenoma: A Case Series and ReviewYan Wang0Yufen An1Xiaomei Hou2Yanan Xu3Zhen Li4Xin Liu5Fumin Zheng6Mingze Sun7Rendong Han8Caixia Lu9Jing Li10Jun Zhou11Department of Obstetrics The Affiliated Hospital of Qingdao University Qingdao ChinaDepartment of Pathology The Affiliated Hospital of Qingdao University Qingdao ChinaDepartment of Obstetrics The Affiliated Hospital of Qingdao University Qingdao ChinaDepartment of Obstetrics The Affiliated Hospital of Qingdao University Qingdao ChinaDepartment of Obstetrics The Affiliated Hospital of Qingdao University Qingdao ChinaDepartment of Obstetrics The Affiliated Hospital of Qingdao University Qingdao ChinaDepartment of Obstetrics The Affiliated Hospital of Qingdao University Qingdao ChinaDepartment of Obstetrics The Affiliated Hospital of Qingdao University Qingdao ChinaDepartment of Obstetrics The Affiliated Hospital of Qingdao University Qingdao ChinaDepartment of Obstetrics The Affiliated Hospital of Qingdao University Qingdao ChinaDepartment of Obstetrics The Affiliated Hospital of Qingdao University Qingdao ChinaDepartment of Obstetrics The Affiliated Hospital of Qingdao University Qingdao ChinaABSTRACT Purpose To present a case series of Cushing's syndrome (CS) during pregnancy caused by adrenocortical adenomas, highlighting clinical features, hormonal assessments and outcomes. Methods We describe five pregnant women with CS, detailing clinical presentations and laboratory findings. Results Common clinical features included a full moon face, buffalo back and severe hypertension. Elevated blood cortisol levels with circadian rhythm disruption and suppressed adrenocorticotrophic hormone (ACTH) levels were observed. Imaging revealed unilateral adrenal tumours. Two cases underwent laparoscopic adrenalectomies during the second trimester, while three had postpartum surgery. All required hormone replacement therapy, with postoperative pathological confirmation of adrenocortical adenomas. Conclusion Diagnosis of CS during pregnancy is challenging due to overlapping features with normal pregnancy: elevated blood cortisol levels and abnormal diurnal rhythm of blood cortisol, suppressed aid diagnosis. Treatment should be individualised due to a lack of explicit optimum therapeutic approaches. Laparoscopic adrenalectomy may be an optimal choice, along with multidisciplinary management including hormone replacement therapy.https://doi.org/10.1002/edm2.474adrenocortical adenomaCushing's syndromepregnancy |
| spellingShingle | Yan Wang Yufen An Xiaomei Hou Yanan Xu Zhen Li Xin Liu Fumin Zheng Mingze Sun Rendong Han Caixia Lu Jing Li Jun Zhou Cushing's Syndrome in Pregnancy Secondary to Adrenocortical Adenoma: A Case Series and Review Endocrinology, Diabetes & Metabolism adrenocortical adenoma Cushing's syndrome pregnancy |
| title | Cushing's Syndrome in Pregnancy Secondary to Adrenocortical Adenoma: A Case Series and Review |
| title_full | Cushing's Syndrome in Pregnancy Secondary to Adrenocortical Adenoma: A Case Series and Review |
| title_fullStr | Cushing's Syndrome in Pregnancy Secondary to Adrenocortical Adenoma: A Case Series and Review |
| title_full_unstemmed | Cushing's Syndrome in Pregnancy Secondary to Adrenocortical Adenoma: A Case Series and Review |
| title_short | Cushing's Syndrome in Pregnancy Secondary to Adrenocortical Adenoma: A Case Series and Review |
| title_sort | cushing s syndrome in pregnancy secondary to adrenocortical adenoma a case series and review |
| topic | adrenocortical adenoma Cushing's syndrome pregnancy |
| url | https://doi.org/10.1002/edm2.474 |
| work_keys_str_mv | AT yanwang cushingssyndromeinpregnancysecondarytoadrenocorticaladenomaacaseseriesandreview AT yufenan cushingssyndromeinpregnancysecondarytoadrenocorticaladenomaacaseseriesandreview AT xiaomeihou cushingssyndromeinpregnancysecondarytoadrenocorticaladenomaacaseseriesandreview AT yananxu cushingssyndromeinpregnancysecondarytoadrenocorticaladenomaacaseseriesandreview AT zhenli cushingssyndromeinpregnancysecondarytoadrenocorticaladenomaacaseseriesandreview AT xinliu cushingssyndromeinpregnancysecondarytoadrenocorticaladenomaacaseseriesandreview AT fuminzheng cushingssyndromeinpregnancysecondarytoadrenocorticaladenomaacaseseriesandreview AT mingzesun cushingssyndromeinpregnancysecondarytoadrenocorticaladenomaacaseseriesandreview AT rendonghan cushingssyndromeinpregnancysecondarytoadrenocorticaladenomaacaseseriesandreview AT caixialu cushingssyndromeinpregnancysecondarytoadrenocorticaladenomaacaseseriesandreview AT jingli cushingssyndromeinpregnancysecondarytoadrenocorticaladenomaacaseseriesandreview AT junzhou cushingssyndromeinpregnancysecondarytoadrenocorticaladenomaacaseseriesandreview |