ECE2017 Eposter Presentations: Adrenal and Neuroendocrine Tumours Adrenal cortex (to include Cushing's) (86 abstracts)
Cushing’s Syndrome During Pregnancy mimicking preeclampsia – case report
Danijela Radojkovic 1, , Milan Radojkovic 1, , Milica Pesic 1, , Slobodan Antic 1, , Sonja Kostic 2 , Sanja Curkovic 2 , Vojislav Ciric 2 & Ivan Ilic 1,
1Medical Faculty, University of Nis, Nis, Serbia; 2Clinic of Endocrinology, Diabetes and Metabolic Disorders, Clinical Center Nis, Nis, Serbia; 3Surgery Clinic, Clinical Center Nis, Nis, Serbia; 4Pathology Institute, Clinical Center Nis, Nis, Serbia.
Introduction: Physiological changes of pregnancy could be similar with classical presentation and biological confirmation of Cushing’s Syndrome (CS). To diagnose CS in pregnancy is very difficult especially in previously healthy women. Since the hypercortisolemia in the pregnancy increase maternal and foetal morbidity it is a concern for endocrinologists, gynaecologists, and paediatricians.
Patient case report: Herein, we present young woman (23 years old) admitted to the Genecology Clinic, with uncontrolled hypertension and gestational diabetes. The pregnancy was terminated with an emergency caesarean section at 28 weeks of gestation due to sever preeclampsia. Five months after delivery hypertension, weight gain, poor glycaemic control, irregular menstrual cycles and cushingoid features persisted. She was admitted to the Endocrinology Clinic for further evaluation. Computed tomography revealed right adrenal adenoma, size 32×41 mm. Endocrine evaluation verified increased cortisol and decreased ACTH. There was no plasma cortisol suppression after low- and high-dose dexamethasone suppression tests. Vanillylmandelic acid in 24 h diuresis, plasma catecholamine and chromogranin serum level, were normal. Potassium was decreased, but other electrolytes (sodium, calcium, phosphorus, magnesium) were in normal range. After adequately preoperative preparation, right adrenalectomy was performed. The procedure and postoperative course were uneventful. The histopathological examination confirmed a benign adrenocortical adenoma.
Conclusion: Even though CS in pregnancy is very rare, it is worthy to be considered when pregnant women develop hypertension and gestational diabetes. Delayed diagnosis and treatment could lead to maternal-foetal complications.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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