Adrenocorticotropin-independent Cushing's syndrome in pregnancy related to overexpression of adrenal luteinizing hormone/human chorionic gonadotropin receptors

作者：Rask E^*; Schvarcz E; Hellman P; Hennings J; Karlsson F A; Rao C V

来源：Journal of Endocrinological Investigation, 2009, 32(4): 313-316.

DOI：10.1007/bf03345718

• Cushing's syndrome
• LH/hCG-receptors
• pregnancy

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 postpartum, 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 26(th) 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. (J. Endocrinol. Invest.

• 出版日期2009-4
• 单位河北医科大学