Cushing’s Syndrome in Pregnancy Secondary to Adrenal Adenoma

Lo, KW; Lau, Tze Kin

doi:10.1159/000009958

Cited by 32 publications

(25 citation statements)

References 17 publications

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“…As in all cases of CS-associated pregnancy, fetal prognosis was poor. Premature births, intrauterine growth retardation, stillbirths, and intrauterine deaths have been reported in all studies (13,(20)(21)(22). The prognosis may be improved by treating the cause of hypercortisolism during pregnancy (13).…”

Section: Discussionmentioning

confidence: 98%

Adrenocortical carcinoma and pregnancy: clinical and biological features and prognosis

Abiven-Lepage¹,

Coste²,

Tissier

et al. 2010

European Journal of Endocrinology

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Objective: Adrenocortical carcinoma (ACC) is a rare, severe disease. Pregnancy-associated ACC has rarely been reported. We wished to evaluate the characteristics and prognosis of ACC diagnosed in patients during pregnancy or in the postpartum period, comparing them with those for ACC diagnosed in nonpregnant women. Design: Clinical presentation, hormonal secretion, staging, survival, and obstetric data are reported. Patients were included between 1963 and 2007. Mean follow-up was 48 months. Patients and methods: This is a retrospective cohort study carried out at a referral center. All female patients aged 16-49 years diagnosed with ACC during the observation period were included (nZ110). Twelve of these women were pregnant or in the first 6 months after delivery. Hormonal secretion, staging, obstetric data, and survival were analyzed. For the survival analysis, pregnant patients were compared with a subgroup of nonpregnant women matched for age, stage, and year of diagnosis (1 pregnant patient/2 controls). Results: Adrenocortical tumors diagnosed during pregnancy or in the postpartum period tend to be more often cortisol-secreting tumors (PZ0.06) and to be discovered at a more advanced stage than those in nonpregnant women, although the differences were not significant. Fetal outcome was poor. Overall survival of the mother was worse than that of matched controls (hazard ratio of death: 3.98, confidence intervalZ1.34-11.85, PZ0.013). Conclusion: ACC diagnosed during pregnancy or in the postpartum period is associated with a poor fetal outcome and a poorer prognosis than ACC diagnosed in nonpregnant women.

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Section: Discussionmentioning

confidence: 98%

Adrenocortical carcinoma and pregnancy: clinical and biological features and prognosis

Abiven-Lepage¹,

Coste²,

Tissier

et al. 2010

European Journal of Endocrinology

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“…Only about 70 pregnancies have been reported in women with Cushing's syndrome. These patients are prone to diabetes mellitus, severe hypertension and preeclampsia, congestive cardiac failure, pulmonary edema or even death [4]. There is also an increased incidence of abortion, stillbirth and neonatal death in these pregnancies.…”

Section: Discussionmentioning

confidence: 99%

Carney Complex – An Unexpected Finding during Puerperium

Schulz

Redlich²,

Köppe³

et al. 2001

Gynecol Obstet Invest

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Carney complex is an extremely rare, autosomal dominant, multi-system disorder characterized by multiple neoplasias and lentiginosis. The genetic defect responsible for this complex has been localized to the short arm of chromosome 2 (2p16). The most prevalent clinical manifestations in patients with Carney complex are spotty skin pigmentation, skin and cardiac myxomas, Cushing’s syndrome and acromegaly. Here we report the case of a 31-year-old woman with a spontaneous pregnancy. At 32 weeks of gestation, she was admitted to our Department of Obstetrics with hypertension and severe back pain. In addition, she had unusual pigmentation and typical cushingoid features. One day after admission, the pregnancy was terminated by emergency cesarian section because of preeclampsia and pathological CTG. During the postoperative period the severe back pain persisted, and radiographic evaluation revealed a collapse of L₂/L₃ with severe osteopenia. A CT scan showed a mass in the right suprarenal area. Histopathological examination revealed a primary pigmented nodular adrenocortical disease. After biochemical confirmation of the diagnosis of Cushing’s syndrome, it was recognized that the patient met the diagnostic criteria for Carney complex.

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“…Хотя симптомы из триады L. Weinstein [4] у беремен-ных и родильниц могут наблюдаться и при других заболе-ваниях с синдромом эндотоксикоза (синдром Иценко-Кушинга, опухоль печени, стеноз почечных артерий, ги-потиреоз, первичный гиперпаратиреоидизм, аспергиллез, холестатический гепатоз, острый жировой гепатоз, гемо-литический уремический синдром, отравление гепатоток-сичными лекарствами, после трансплантации печени, по-сле спленэктомии при идиопатической тромбоцитопени-ческой пурпуре), в настоящее время общепризнано, что HELLP-синдром всегда вторичен, присущ именно про-грессирующей, тяжелой ПЭ [8,9].…”

Section: 4unclassified

Efferent therapy as a measure for the prevention and treatment of HELLP syndrome

Vetrov¹,

Vladimirova²,

Иванов³

et al. 2016

Ross. vestn. akush.-ginekol.

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Российский вестник акушеРа-гинеколога 4, 2016посТДипломное оБучение © Коллектив авторов, 2016 В акушерской практике HELLP-синдром встречается в 0,3-0,4% случаев ко всем родам и в 3-12% случаев тя-желой преэклампсии (ПЭ), сопровождаясь высокой мате-ринской летальностью (24-75%) и перинатальной смерт-ностью (79-90 на 1000 родившихся живыми и мертвыми) [1,2]. e-mail: vetrovplasma@mail.ru В клиническом плане следует подчеркнуть несколько особенностей, присущих HELLP-синдрому.Первая особенность. Еще в 90-е годы XX века призна-валось, что тяжелую форму ПЭ беременных можно диа-гностировать при наличии одного из 5 критериев: 1) дву-кратно, через 6 ч, определяемые систолическое давление

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Cushing’s Syndrome in Pregnancy Secondary to Adrenal Adenoma

Cited by 32 publications

References 17 publications

Adrenocortical carcinoma and pregnancy: clinical and biological features and prognosis

Adrenocortical carcinoma and pregnancy: clinical and biological features and prognosis

Carney Complex – An Unexpected Finding during Puerperium

Efferent therapy as a measure for the prevention and treatment of HELLP syndrome

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