Endogenous Cushing’s syndrome during pregnancy

Younes, Nada; St-Jean, Matthieu; Bourdeau, Isabelle; Lacroix, André

doi:10.1007/s11154-022-09731-y

Cited by 12 publications

(7 citation statements)

References 114 publications

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“…It is noteworthy similar illicit LHCGR expression has been described in adrenal Cushing’s syndrome in pregnancy [ 40 ]; and in aldosterone-producing adenomas presenting in puberty, pregnancy or menopause, associated with somatic CTNNB1 mutations in combination with GNA11 or GNAQ mutations [ 41 ]. It will be interesting to see whether LHCGR expression is similarly elevated in PPGLs presenting in puberty or at menopause.…”

Section: Expression Of Lhcgr In Pheochromocytomasmentioning

confidence: 82%

The diagnosis and management of pheochromocytoma and paraganglioma during pregnancy

Clifton‐Bligh

2023

Rev Endocr Metab Disord

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Diagnosis of pheochromocytoma or paraganglioma (PPGL) in pregnancy has been associated historically with high rates of materno-fetal morbidity and mortality. Recent evidence suggests outcomes are improved by recognition of PPGL before or during pregnancy and appropriate medical management with alpha-blockade. Whether antepartum surgery (before the third trimester) is required remains controversial and open to case-based merits. Women with PPGL in pregnancy are more commonly delivered by Caesarean section, although vaginal delivery appears to be safe in selected cases. At least some PPGLs express the luteinizing hormone/chorionic gonadotropin receptor (LHCGR) which may explain their dramatic manifestation in pregnancy. PPGLs in pregnancy are often associated with heritable syndromes, and genetic counselling and testing should be offered routinely in this setting. Since optimal outcomes are only achieved by early recognition of PPGL in (or ideally before) pregnancy, it is incumbent for clinicians to be aware of this diagnosis in a pregnant woman with hypertension occurring before 20 weeks’ gestation, and acute and/or refractory hypertension particularly if paroxysmal and accompanied by sweating, palpitations and/or headaches. All women with a past history of PPGL and/or heritable PPGL syndrome should be carefully assessed for the presence of residual or recurrent disease before considering pregnancy.

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Section: Expression Of Lhcgr In Pheochromocytomasmentioning

confidence: 82%

The diagnosis and management of pheochromocytoma and paraganglioma during pregnancy

Clifton‐Bligh

2023

Rev Endocr Metab Disord

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“…ACTH‐dependent CS product excessive levels of androgens hinder the production of gonadotrophins, which disrupt normal follicular development, resulting in anovulation, amenorrhea and, ultimately, infertility. In contrast, ACTH‐independent CS generally generates cortisol alone, lightly impacting ovulatory function [ 11 ]. ACTH‐independent CS primarily occurs due to adrenocortical adenomas, which make up approximately 15% of CS cases (compared with 40%–60% in pregnant individuals) [ 5 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

Cushing's Syndrome in Pregnancy Secondary to Adrenocortical Adenoma: A Case Series and Review

Wang,

An,

Hou

et al. 2024

Endocrino Diabet & Metabol

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PurposeTo present a case series of Cushing's syndrome (CS) during pregnancy caused by adrenocortical adenomas, highlighting clinical features, hormonal assessments and outcomes.MethodsWe describe five pregnant women with CS, detailing clinical presentations and laboratory findings.ResultsCommon 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.ConclusionDiagnosis 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.

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“…Similarly, hypertension and hyperglycemia also occurred in 1 st or 2 nd trimester. Adrenal adenoma would secrect cortisol which affects the blood sugar metabolism and balance, resulting hyperglycemia and hypertension earlier than pregnancy complicated with hypertension or gestational diabetes mellitus [24] . Besides, adrenal adenoma which secrects aldosterone or catecholamine, leads to hypertension and hypokalemia as early as onset of adrenal adenoma [25] .…”

Section: Discussionmentioning

confidence: 99%

Adrenal Adenoma dignosed during pregnancy: A 20-year experience at a tertiary center

Zhu

Cai

Zhang

et al. 2023

Preprint

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Background Adrenal adenoma during pregnancy is rare and the diagnosis is challenging owing to unspecific symdromes and restricted investigation. It’s poorly described obstetric outcomes of patients underwent surgery during pregnancy or only received medicine treatment. To report the clinical characteristics and obstetric outcomes of pregnant women complicated with adrenal adenoma. Methods A retrospective study was performed. The clinical characteristics, management and obstetric outcome of pregnancies diagnosed as adrenal adenoma over 20 years were reviewed from a teriary hospital. Results A total of 12 women were diagnosed as adrenal adenoma during pregnancy from to January 2000 to September 2022. Eight women had cortisol-secreting adrenal adenoma, two had over-secrete catecholamine and two primary aldosteronism. The original symptoms adrenal adenoma during pregnancy included hypertension or preeclampsia, gestational diabetes mellitus or pre-pregnancy diabetes mellitus, hypokalemia and ecchymosis. There were four women took adrenalectomy during pregnancy, while 8 women only received medicine therapy. Preterm birth occurred in all cases who received medicine, whereas 1 case suffered from preterm birth in the group underwent surgery. Among the 8 women of medicine group, there were 3 neonatal death. Conclusions Once simultaneous onset of hypertension, hyperglycemia and hypokalemia during the 1st or 2nd trimester, adrenal adenoma should be investigate by laboratory examination and imaging examination. The maternal and fetal outcome were unpredictive owing to the severity of adrenal adenoma, particular in patients only received medicine treatment. Adrenalectomy should be recommended during the pregnancy.

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Endogenous Cushing’s syndrome during pregnancy

Cited by 12 publications

References 114 publications

The diagnosis and management of pheochromocytoma and paraganglioma during pregnancy

The diagnosis and management of pheochromocytoma and paraganglioma during pregnancy

Cushing's Syndrome in Pregnancy Secondary to Adrenocortical Adenoma: A Case Series and Review

Adrenal Adenoma dignosed during pregnancy: A 20-year experience at a tertiary center

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