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Kim, Sung, Park, Han, Han, Sim, Oh, and Jeon: A Case of Cushing's Disease in Pregnancy
Case Report
Endocrinology and Metabolism

Endocrinology and Metabolism 2011; 26(4): 348-354.

Published online: 21 December 2011

DOI: https://doi.org/10.3803/EnM.2011.26.4.348

A Case of Cushing's Disease in Pregnancy

Jeong Tae Kim, Mun Hyuk Sung, Woo Ri Park, Jeong Ho Han, Hye Suk Han, Young Kwang Sim, Tae Gun Oh, Hyun Jeong Jeon

Department of Internal Medicine, Chungbuk National University College of Medicine, Cheongju, Korea.

Corresponding author: Hyun Jeong Jeon. Department of Internal Medicine, Chungbuk National University Hospital, Chungbuk National University College of Medicine, 410 Gaesin-dong, Heungdeok-gu, Cheongju 361-711, Korea. Tel: +82-43-269-6352, Fax: +82-43-273-3252, endoann@nate.com

Received 12 May 2011       Accepted 26 July 2011

Copyright © 2011 Korean Endocrine Society

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Developing Cushing's syndrome during pregnancy is rare because menstruation is irregular and hypercortisolism causes infertility. Developing Cushing's disease during pregnancy is very rare because there is even less ovulation than those with the adrenal adenoma. The clinical manifestations of Cushing's syndrome may easily be missed during pregnancy as the features of weight gain, hypertension, and hyperglycemia overlap with those that occur during a pregnancy. Diagnosing Cushing's syndrome during a pregnancy is complex because the biochemical features are obscured by the natural changes in the hypothalamic-pituitary-adrenal axis that occur during pregnancy. Having Cushing's syndrome during a pregnancy results in increased fetal and maternal complications, so early diagnosis and treatment are critical. We report the clinical and endocrine findings of a pregnant women with Cushing's disease who underwent transsphenoidal surgery after delivery.

Keywords: Cushing's disease, Cushing's syndrome, Pregnancy

Figures and Tables

Fig. 1
T1 noncontrast magnetic resonance imaging of sagittal (A) and coronal (B) views of a 1.3 cm complicated cystic mass at the sellar floor.
enm-26-348-g001
Fig. 2
Abdomen magnetic resonance imaging shows simple cyst in the right kidney, otherwise there is no remarkable findings in the both adrenal glands.
enm-26-348-g002
Fig. 3
T1 noncontrast magnetic resonance imaging of sagittal (A) and coronal (B) views show increased size of complicated cystic mass at the sellar floor.
enm-26-348-g003
Fig. 4
A. Histological examination of the operative specimen showed pituitary adenoma with near total necrosis (H&E stain, × 40). B. Immunohistochemical stains were positive for adrenocortical hormone (immunohistochemistry ACTH, × 100).
enm-26-348-g004
Fig. 5
After transsphenoidal surgery, the complicated cystic mass was disappeared at the pituitary lesion.
enm-26-348-g005
Table 1
Clinical features and hormone levels according to gestational age prior to surgery
enm-26-348-i001

ACTH, adrenocortical hormone; BP, blood pressure.

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