Mulder W J, Berghout A, Wiersinga W M
Department of Medicine, University of Amsterdam.
Neth J Med. 1990 Jun;36(5-6):234-41.
Two cases of Cushing's syndrome during pregnancy are reported, both due to an adrenal adenoma. The association of pregnancy and Cushing's syndrome has up to now been described in 48 patients (including our two cases); Cushing's syndrome was ACTH-independent in 59%, ACTH-dependent in 33%, and of unknown cause in 8%. The obvious preponderance of ACTH-independent Cushing's syndrome in pregnancy--in contrast to the higher prevalence of ACTH-dependent Cushing's syndrome in the nonpregnant state--is unexplained, but might be related to less severe hypercortisolism in patients with adrenal adenoma. Active treatment of Cushing's syndrome in pregnancy is associated with a slightly but not significantly better outcome of pregnancy.
本文报告了两例孕期库欣综合征病例，均由肾上腺腺瘤引起。截至目前，已有48例（包括我们的两例）报道了妊娠与库欣综合征的关联；其中59%的库欣综合征为促肾上腺皮质激素（ACTH）非依赖性，33%为ACTH依赖性，8%病因不明。孕期ACTH非依赖性库欣综合征明显占优势——与非孕期ACTH依赖性库欣综合征的较高患病率形成对比——其原因尚不清楚，但可能与肾上腺腺瘤患者皮质醇增多症较轻有关。孕期积极治疗库欣综合征与妊娠结局稍有改善但无显著差异相关。
