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Persistent vs Recurrent Cushing's Disease Diagnosed Four Weeks Postpartum
Leena Shah1, Emily V Nosova1, Joshua B Bederson2
1Division of Endocrinology, Diabetes, and Bone Disease, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Case Reports in Endocrinology
|August 23, 2022
Summary
Recurrent Cushing's disease (CD) after a dormant pregnancy is a rare occurrence. This case highlights postpartum CD recurrence, emphasizing the need for further research into pregnancy-related hormonal influences on CD.
Area of Science:
- Endocrinology
- Reproductive Medicine
- Oncology
Background:
- Cushing's disease (CD) recurrence during pregnancy is often linked to estradiol fluctuations.
- Postpartum recurrence of CD, particularly after a dormant pregnancy, is not well-documented.
- Understanding CD recurrence in pregnancy is crucial for reproductive-aged women.
Observation:
- A 30-year-old woman with CD experienced symptom improvement after transsphenoidal surgery.
- She conceived unexpectedly postpartum and had no signs of CD during pregnancy.
- CD recurred four weeks after delivery, necessitating repeat surgery and medical management.
Findings:
- This case presents the first report of recurrent CD that was quiescent during pregnancy.
- The patient required bilateral adrenalectomy due to persistent, uncontrolled hypercortisolism post-repeat surgery.
- The study underscores the potential for CD recurrence in the peripartum period.
Implications:
- Further research is needed to elucidate the mechanisms of postpartum CD recurrence.
- This case informs counseling for women of reproductive age with a history of CD and family planning considerations.
- Monitoring for CD recurrence in the postpartum period is essential.
