Diri Halit, Bayram Fahri, Simsek Yasin, Ozkan Yusuf, Akcan Alper, Karahan Ibrahim, Ileri Ibrahim, Aribas Sulbiye, Koc Mehmet Sait
Division of Endocrinology, Erciyes University Medical School, 38039 Kayseri, Turkey.
Division of Endocrinology, Firat University Medical School, 23000 Elazığ, Turkey.
Case Rep Endocrinol. 2014;2014:283458. doi: 10.1155/2014/283458. Epub 2014 Dec 3.
Cushing's syndrome (CS) may lead to severe maternal and fetal morbidities and even mortalities in pregnancy. However, pregnancy complicates the diagnosis and treatment of CS. This study describes a 26-year-old pregnant woman admitted with hypertension-induced headache. Hormonal analyses performed due to her cushingoid phenotype revealed a diagnosis of adrenocorticotropic hormone- (ACTH-) independent CS. MRI showed a 3.5 cm adenoma in her right adrenal gland. After preoperative metyrapone therapy, she underwent a successful unilateral laparoscopic adrenalectomy at 14-week gestation. Although she had a temporary postoperative adrenal insufficiency, hormonal analyses showed that she has been in remission since delivery. Findings in this patient, as well as those in previous patients, indicate that pregnancy is not an absolute contraindication for laparoscopic adrenalectomy. Rather, such surgery should be considered a safe and efficient treatment method for pregnant women with cortisol-secreting adrenal adenomas.
库欣综合征(CS)在孕期可能导致严重的母婴发病甚至死亡。然而,怀孕会使CS的诊断和治疗变得复杂。本研究描述了一名26岁因高血压性头痛入院的孕妇。因其库欣样表型进行的激素分析显示诊断为促肾上腺皮质激素(ACTH)非依赖性CS。MRI显示其右肾上腺有一个3.5厘米的腺瘤。术前使用甲吡酮治疗后,她在妊娠14周时成功接受了单侧腹腔镜肾上腺切除术。尽管术后她出现了暂时性肾上腺功能不全,但激素分析显示自分娩后她已缓解。该患者以及先前患者的发现表明,怀孕并非腹腔镜肾上腺切除术的绝对禁忌证。相反,对于患有分泌皮质醇的肾上腺腺瘤的孕妇,这种手术应被视为一种安全有效的治疗方法。