Adrenal Disorders in Pregnancy

Lindsay, John R.; Nieman, Lynnette K.

doi:10.1016/j.ecl.2005.09.010

Cited by 45 publications

(22 citation statements)

References 83 publications

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“…Moreover, ACC generally affects women at a younger age than men (Luton et al 1990). The prevalence of adrenocortical tumors is particularly high during pregnancy, accounting for 70% of all cases of Cushing's syndrome (CS) diagnosed in pregnant women (Guilhaume et al 1992, Lindsay & Nieman 2006, versus only about 25% of cases of CS diagnosed in non-pregnant patients. A few cases of pregnancydependent CS have been reported elsewhere (Caticha et al 1993, Close et al 1993, Wallace et al 1996, Kasperlik-Zaluska et al 2000.…”

Section: Introductionmentioning

confidence: 99%

Expression of progesterone and estradiol receptors in normal adrenal cortex, adrenocortical tumors, and primary pigmented nodular adrenocortical disease

Crémoux

Rosenberg²,

Goussard³

et al. 2008

Endocrine Related Cancer

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Adrenal tumors occur more frequently in women and are the leading cause of Cushing's syndrome during pregnancy. We aimed to evaluate the potential role of sex steroids in the susceptibility of women to adrenocortical tumors. We evaluated the presence of the progesterone receptor (PR), estradiol receptors (ERs), and aromatase in 5 patients with primary pigmented nodular adrenal disease (PPNAD), 15 adrenocortical adenomas (ACAs) and adjacent normal tissues, 12 adrenocortical carcinomas (ACCs), and 3 normal adrenal glands (NA). The expression of PR and ERa was evaluated by enzyme immunoassays, real-time RT-PCR, immunohistochemistry, and cytosol-based ligand-binding assays. ERb and aromatase levels were evaluated by real-time RT-PCR. ERa concentrations were low in NA, in adrenal tissues adjacent to ACA (51G33), in ACC (53G78), and lower in ACA (11G11 fmol/mg DNA). Conversely, PR concentrations were high in NA and adrenal tissues adjacent to ACA, at 307G216 fmol/mg DNA, and were even higher in tumors -726G706 fmol/mg DNA in ACA and 1154G1586 fmol/mg DNA in ACC -and in isolated PPNAD nodules. Binding study results in four tumors were compatible with binding to a steroid receptor. In patients with PPNAD, a strong positive immunohistochemical signal was associated with the sole isolated nodular regions. ERb transcript levels were very high in all samples except those for two ACCs, whereas aromatase levels were low. PR and ERb are clearly present in normal adrenal glands and adrenal tumors. Further studies may shed light on the possible pathogenic role of these receptors in adrenal proliferation.

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Section: Introductionmentioning

confidence: 99%

Expression of progesterone and estradiol receptors in normal adrenal cortex, adrenocortical tumors, and primary pigmented nodular adrenocortical disease

Crémoux

Rosenberg²,

Goussard³

et al. 2008

Endocrine Related Cancer

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show abstract

“…The urinary free cortisol (UFC) concentration also increases, and dexamethasone does not suppress plasma cortisol to the same degree as that during a nonpregnant state [37]. Current data suggest that a combination of UFC concentrations greater than 3 times the upper normal limit and elevated midnight plasma or salivary cortisol concentrations could be the best strategies for screening and diagnosis of CS during pregnancy [38].…”

Section: Discussionmentioning

confidence: 96%

Cushing’s syndrome during pregnancy caused by adrenal cortical adenoma: a case report and literature review

Wang

Yuan

2015

Front. Med.

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Cushing's syndrome (CS) during pregnancy is a rare condition with significant maternal and fetal complications. A case of CS during the third trimester of pregnancy secondary to adrenocortical adenoma was reported. Literature review revealed the disadvantages of different treatments in this period. Besides the conservative treatment, surgery is recommended for CS during the third trimester of pregnancy secondary to adrenal adenoma, if an experienced surgeon is available.

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“…There have been at least 200 cases reported in pregnancy and the prevalence is estimated at one in 54,000. 3,4 It is important to suspect and diagnose these tumours because: † Hypertension is potentially curable with resection of the tumour; † The cardiovascular complications are potentially lethal; † At least 10% of these tumours are malignant; and † A hereditary basis may be found in up to 24% of patients and detection of phaeochromocytoma in the proband may result in early diagnosis in other affected family members. 6 -8 The most common clinical presentation of phaeochromocytoma includes headaches, palpitations, diaphoresis and hypertension.…”

Section: Discussionmentioning

confidence: 99%

“…4,11,12 In pregnancy, paroxysms can be precipitated by stress, increasing intra-abdominal pressure, medications such as metoclopramide, fetal movements and vaginal delivery. The ensuing hypertensive crisis can be detrimental to both mother and fetus.…”

Section: Discussionmentioning

confidence: 99%

Pheochromocytoma in pregnancy: a case report and review of literature

George

Tan

2010

Obstet Med

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Summary: Hypertension is a common problem in pregnancy that can result in significant maternal and fetal morbidity and mortality. The common causes include pre-eclampsia, gestational hypertension and essential hypertension. Although phaeochromocytoma is a rare cause of hypertension in pregnancy, it can lead to potentially life-threatening cardiovascular complications for the mother and increased fetal mortality if left undiagnosed and untreated. The diagnosis can be confirmed by measurement of plasma and urinary catecholamines and their metabolities followed by radiological localization of the tumour. Surgical resection of the tumour after adequate pre-operative control of hypertension using sequential alpha-followed by betablockers is the definitive treatment. In pregnancy, depending on the gestation at which diagnosis is made, the optimal timing for surgery is during the late first or early second trimester. When the pregnancy is more advanced, medical management followed by combined caesarean section and tumour resection closer to term is preferred.

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Adrenal Disorders in Pregnancy

Cited by 45 publications

References 83 publications

Expression of progesterone and estradiol receptors in normal adrenal cortex, adrenocortical tumors, and primary pigmented nodular adrenocortical disease

Expression of progesterone and estradiol receptors in normal adrenal cortex, adrenocortical tumors, and primary pigmented nodular adrenocortical disease

Cushing’s syndrome during pregnancy caused by adrenal cortical adenoma: a case report and literature review

Pheochromocytoma in pregnancy: a case report and review of literature

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