Kamata Yuji, Hayashi Akinori, Ogawa Akifumi, Ichikawa Raishi, Moriya Tatsumi, Shichiri Masayoshi
Department of Endocrinology, Diabetes and Metabolism, Kitasato University School of Medicine, Japan.
Intern Med. 2011;50(18):1981-5. doi: 10.2169/internalmedicine.50.5401. Epub 2011 Sep 15.
Women with congenital adrenal hyperplasia (CAH) caused by steroid 21-hydroxylase deficiency show reduced fertility, especially with the salt-wasting form. A 27-year-old pregnant woman with this disease underwent laparotomy and oophorectomy to remove a multilocular ovarian tumor at 14 weeks of pregnancy. This proved to be a mucinous cystadenoma. Toward the third trimester, she presented with marked elevations of 17α-hydroxyprogesterone and plasma renin activity. Careful management of endocrine and body fluid homeostasis allowed her to give birth to a healthy female infant with normal external genitalia. This case illustrates endocrinological parameters during pregnancy in a woman with classical salt-wasting CAH.
由类固醇21-羟化酶缺乏引起的先天性肾上腺皮质增生症(CAH)女性的生育能力降低,尤其是失盐型患者。一名患有该疾病的27岁孕妇在妊娠14周时接受了剖腹手术和卵巢切除术,以切除一个多房性卵巢肿瘤。结果证实为黏液性囊腺瘤。到妊娠晚期,她出现17α-羟孕酮和血浆肾素活性显著升高。通过对内分泌和体液稳态的精心管理,她生下了一名外生殖器正常的健康女婴。该病例说明了经典失盐型CAH女性在孕期的内分泌参数。