Abstract |
Cushing's syndrome during pregnancy is rare, and rather than being of pituitary origin most patients exhibit ACTH-independent adrenal hypercortisolism. In some cases the syndrome has spontaneously resolved post partum, suggesting the presence of a pregnancy-associated stimulatory factor(s). We describe a case with aberrant adrenal LH/hCG receptors in a large adrenal tumor as a possible explanation for cortisol hypersecretion and tumor growth in Cushing s syndrome during pregnancy. A 27-yr-old woman presented with hypertension and diabetes mellitus in early pregnancy. Investigations revealed hypercortisolemia, suppressed ACTH-levels, and a 6.4- cm right adrenal tumor. The tumor was successfully removed by laparoscopy at 26th week of pregnancy. Hypercortisolism and hypertension resolved post-operatively. The tumor displayed higher LH/hCG receptor mRNA and protein positivity than adjacent normal adrenal tissue as examined by in situ hybridization and immunocytochemistry. High physiological levels of hCG, in conjunction with aberrant adrenal LH/hCG receptor overexpression, may have contributed to the development of Cushing's syndrome in pregnancy.
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Authors | E Rask, E Schvarcz, P Hellman, J Hennings, F A Karlsson, C V Rao |
Journal | Journal of endocrinological investigation
(J Endocrinol Invest)
Vol. 32
Issue 4
Pg. 313-6
(Apr 2009)
ISSN: 1720-8386 [Electronic] Italy |
PMID | 19636197
(Publication Type: Case Reports, Journal Article)
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Chemical References |
- RNA, Messenger
- Receptors, LH
- Adrenocorticotropic Hormone
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Topics |
- Adrenal Gland Neoplasms
(complications, diagnosis, metabolism)
- Adrenocorticotropic Hormone
(metabolism)
- Adult
- Cushing Syndrome
(complications, diagnosis, metabolism)
- Female
- Humans
- Immunoenzyme Techniques
- Pregnancy
- Pregnancy Complications, Neoplastic
- RNA, Messenger
(metabolism)
- Receptors, LH
(genetics, metabolism)
- Reverse Transcriptase Polymerase Chain Reaction
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