Document Detail


Adrenocorticotropin-independent Cushing's syndrome in pregnancy related to overexpression of adrenal luteinizing hormone/human chorionic gonadotropin receptors.
MedLine Citation:
PMID:  19636197     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
E Rask; E Schvarcz; P Hellman; J Hennings; F A Karlsson; C V Rao
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of endocrinological investigation     Volume:  32     ISSN:  1720-8386     ISO Abbreviation:  J. Endocrinol. Invest.     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-07-28     Completed Date:  2009-10-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806594     Medline TA:  J Endocrinol Invest     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  313-6     Citation Subset:  IM    
Affiliation:
Department of Medicine, Orebro University Hospital, 70185 Orebro, Sweden. eva.rask@orebroll.se
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MeSH Terms
Descriptor/Qualifier:
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
Chemical
Reg. No./Substance:
0/RNA, Messenger; 0/Receptors, LH; 9002-60-2/Adrenocorticotropic Hormone

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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