title: Pregnancy and Cushing's syndrome: example of endocrine interaction.
abstract: Pregnancy rarely occurs in women with Cushing's syndrome, and when it does, fetal mortality and morbidity are very high. We describe a 30-year-old woman who was found to have severe Cushing's syndrome in the 22nd week of her first pregnancy, after a year of unsuccessful attempts to conceive. The patient had the majority of the symptoms and signs characteristic of the syndrome. Laboratory examinations revealed hypokalemia of 2.7 mEq/l, serum cortisol 39.5 micrograms/dl without diurnal variation, free urinary cortisol 1,850 to 3,500 micrograms/24 h, 17-hydroxycorticosteroids (OHCS) 52.5 mg/24 h, 17-ketosteroids (KS) 12 mg/24 h, and ACTH 29 pg/ml. No suppression was observed upon dexamethasone administration (2 and 8 mg). Ultrasound examination of the adrenal glands revealed a left adrenal tumor with a diameter of 4.2 cm. An adrenocortical adenoma was successfully excised in the 24th week of pregnancy. During the 37th week of pregnancy, she delivered a normal baby girl. Postoperatively, the patient was put on maintenance therapy. One year after delivery, mother and child are in perfect health.
authors.affiliation: Department of Medicine C, Rokach (Hadassah) Hospital, Tel Aviv, Israel.
authors.forename: E
authors.initials: E
authors.lastname: Barasch
authors.forename: M
authors.initials: M
authors.lastname: Sztern
authors.forename: S
authors.initials: S
authors.lastname: Spinrad
authors.forename: R
authors.initials: R
authors.lastname: Chayen
authors.forename: C
authors.initials: C
authors.lastname: Servadio
authors.forename: H
authors.initials: H
authors.lastname: Kaufman
authors.forename: M
authors.initials: M
authors.lastname: Ben Bassat
authors.forename: I
authors.initials: I
authors.lastname: Blum
mesh_terms: D000236:Adenoma / Q000150:complications / Q000601:surgery; D000305:Adrenal Cortex Hormones / Q000097:blood; D000306:Adrenal Cortex Neoplasms / Q000150:complications / Q000601:surgery; D000315:Adrenalectomy; D000328:Adult; D003480:Cushing Syndrome / Q000175:diagnosis* / Q000628:therapy; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011263:Pregnancy Trimester, Third; D014463:Ultrasonography
chemical_list: D000305:Adrenal Cortex Hormones