J Korean Soc Endocrinol.  2003 Oct;18(5):489-495.

A Case of Cushing's Syndrome Complicating Pregnancy Adrenalectomized after Delivery

• Cho JS
• Jeon JS
• Ahn KJ
• Kim BJ
• Kwon SH
• Lee EG
• Choi WW
• Park SW
• Lee WM

Abstract

Pregnancy is rare in women with Cushing's syndrome, as the associated infertility is related to excess cortisol and/or androgen. However, approximately 100 such cases have been reported, with 50% due to an adrenal cortical adenoma. Establishing a diagnosis and cause can be difficult. Clinically, striae, hypertension and gestational diabetes are common features in pregnancy, with hypertension and diabetes being the most common signs of Cushing's syndrome in pregnant women. Furthermore, biochemically, a normal pregnancy is associated with a several fold increase in plasma cortisol, as the increased cortisol production rate also increases the cortisol binding protein. Untreated, the condition results in high maternal and fetal morbidity and mortality. An adrenal or pituitary adenoma should be excised, but a metyrapone, which is not teratogenic, has been effective in controlling many cases of excess cortisol. Here, a case of Cushing's syndrome, complicating a pregnancy due to an adrenal cortical adenoma, with thorough obstetric and medical management, including a metyrapone, which was adrenalectomized after delivery, is reported.

MeSH Terms

Adrenocortical Adenoma
Carrier Proteins
Cushing Syndrome*
Diabetes, Gestational
Diagnosis
Female
Humans
Hydrocortisone
Hypertension
Infertility
Metyrapone
Mortality
Pituitary Neoplasms
Plasma
Pregnancy*
Pregnant Women
Carrier Proteins
Hydrocortisone
Metyrapone