Journal of Korean Endocrine Society 2003;18(5):489-495.
Published online October 1, 2003.
A Case of Cushing's Syndrome Complicating Pregnancy Adrenalectomized after Delivery.
Jeong Soo Cho, Jae Seok Jeon, Kyu Jeong Ahn, Byoung Joon Kim, Sung Ho Kwon, Eun Gyu Lee, Won Wook Choi, Sang Won Park, Won Mee Lee
1Department of Internal Medicine, Eulji Medical College, Seoul, Korea.
2Department of Pathology, Eulji Medical College, Seoul, Korea.
Pregnancy is rare in women with Cushing's syndrome, as the associated infertility is related to excess cortisol and/or androgen. However, approximately 100 such cases have been reported, with 50% due to an adrenal cortical adenoma. Establishing a diagnosis and cause can be difficult. Clinically, striae, hypertension and gestational diabetes are common features in pregnancy, with hypertension and diabetes being the most common signs of Cushing's syndrome in pregnant women. Furthermore, biochemically, a normal pregnancy is associated with a several fold increase in plasma cortisol, as the increased cortisol production rate also increases the cortisol binding protein. Untreated, the condition results in high maternal and fetal morbidity and mortality. An adrenal or pituitary adenoma should be excised, but a metyrapone, which is not teratogenic, has been effective in controlling many cases of excess cortisol. Here, a case of Cushing's syndrome, complicating a pregnancy due to an adrenal cortical adenoma, with thorough obstetric and medical management, including a metyrapone, which was adrenalectomized after delivery, is reported.
Key Words: Adrenal adenoma, Cushing's syndrome, Pregnancy, Metyrapone

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