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UNCOMPLICATED PREGNANCY IN A PATIENT WITH CUSHING'S DISEASE.

S Ciftci Dogansen¹, B Canbaz¹, B Canbaz²

¹Istanbul University, Istanbul Faculty of Medicine, Department of Internal Medicine, Istanbul, Turkey.

Acta Endocrinologica (Bucharest, Romania : 2005)

|June 1, 2019

Summary

Cushing

Keywords:

Cushing’s disease Pregnancy conservative treatment hypercortisolemia

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Area of Science:

Endocrinology
Reproductive Medicine
Oncology

Background:

Cushing's syndrome (CS) in pregnancy is rare due to hormonal interactions affecting fertility.
Adrenocorticotropic hormone (ACTH)-dependent CS is less common than adrenal causes during gestation.
Diagnosing CS in pregnancy is challenging due to physiological axis changes and limited imaging.

Observation:

A 27-year-old pregnant woman was diagnosed with Cushing's disease (CD) at 5 weeks gestation.
Mild hypercortisolism symptoms presented minimal complications for mother and fetus.
Insulin was the sole treatment; pregnancy concluded with a healthy infant delivery at 38 weeks.

Findings:

The infant showed no complications like hypocortisolemia or hypoglycemia.
Postpartum evaluation confirmed CD, with pituitary microadenoma identified via MRI.
Histopathology confirmed ACTH-positive pituitary adenoma, treated with transsphenoidal surgery.

Implications:

Mild Cushing's disease can be managed during pregnancy with close maternal and fetal monitoring.
Successful pregnancy outcomes are possible despite the complexities of CS.
Early diagnosis and management are crucial for favorable outcomes in pregnant CS patients.