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Cushing Syndrome in Pregnancy Secondary to an Adrenal Cortical Adenoma
Author(s) -
MacGibbon A. L.,
Brieger G. M.
Publication year - 1995
Publication title -
australian and new zealand journal of obstetrics and gynaecology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.734
H-Index - 65
eISSN - 1479-828X
pISSN - 0004-8666
DOI - 10.1111/j.1479-828x.1995.tb01878.x
Subject(s) - medicine , pregnancy , gestational diabetes , adrenal adenoma , diabetes mellitus , cushing syndrome , gestation , adrenocortical adenoma , obstetrics , pediatrics , adenoma , endocrinology , genetics , biology
EDITORIAL COMMENT: We accepted this case report for publication because of the lesson that diagnosis of severe gestational diabetes indicates the need for consideration of an underlying cause other than hormones from the fetoplacental unit. In the other case of Cushing syndrome published in our journal (Kriplani and colleagues. Aust NZ J Obstet Gynaecol 1993; 33:428‐430) the woman had had diabetes requiring insulin for 3 years and investigations at 10 weeks' gestation were suggestive of pituitary‐dependent Cushing syndrome. Summary: Cushing syndrome in pregnancy is rare. This is explained by the syndrome's association with amenorrhoea, oligomenorrhoea, infertility and abortions. Cushing syndrome commonly presents with hypertension, weight gain, diabetes, striae or truncal obesity, all of which can be consistent with pregnancy in women without Cushing syndrome. We describe a case of Cushing syndrome in pregnancy secondary to an adrenal cortical tumour which was discovered after an abnormal glucose tolerance test. The woman developed classical features of Cushing syndrome including gestational diabetes and hypertension and was managed successfully to term after a unilateral adrenalectomy at 23 weeks. The case is reported not only because of its rarity but also because the diagnosis was made after a routine screening test for gestational diabetes. Early diagnosis and treatment of adrenal adenoma causing Cushing syndrome in pregnancy reduces maternal and fetal morbidity and mortality.