A Rare Occurrence of Premature Birth and Recurrent Acute Pulmonary Oedema in the Mother due to Cushing’s Syndrome

A Case Report

Keywords: Cushing’s syndrome, pregnancy, acute pulmonary oedema

Abstract

Presentation of Cushing’s syndrome during pregnancy is extremely rare. We report a 21-year-old female with Cushing’s syndrome diagnosed at 23 weeks of gestation and had recurrent acute pulmonary oedema during the antepartum and postpartum period. She delivered prematurely via emergency caesarean section at 28 weeks of gestation. This case highlights the rare occurrence of recurrent acute pulmonary oedema during pregnancy and consequential premature birth in a patient with adrenal Cushing’s. She was diagnosed with adrenal Cushing’s during the postpartum period based on unsuppressed serum cortisol after overnight and low-dose dexamethasone suppression test with a suppressed ACTH. CT scan of the adrenal glands revealed a right adrenal cortical adenoma. The risk of complications in infants and mothers who suffer from Cushing’s syndrome needs to be handled carefully. The diagnosis of Cushing’s syndrome in pregnant women often overlaps and is difficult to establish in early pregnancy.

Downloads

Download data is not yet available.

References

Caimari F, Valassi E, Garbayo P, et al. Cushing’s syndrome and pregnancy outcomes: A systematic review of published cases. Endocrine. 2017;55(2):555–63. https://pubmed.ncbi.nlm.nih.gov/27704478. https://doi.org/10.1007/s12020-016-1117-0.

Machado MC, Fragoso MCBV, Bronstein MD. Pregnancy in patients with Cushing’s syndrome. Endocrinol Metab Clin North Am. 2018; 47(2):441-9. PMID: 29754643. https://pubmed.ncbi.nlm.nih.gov/

https://doi.org/10.1016/j.ecl.2018.02.004.

Brue T, Amodru V, Castinetti F. Management of endocrine diseases: Management of Cushing’s syndrome during pregnancy: Solved and unsolved questions. Eur J Endocrinol. 2018;178(6):R259-66. https://pubmed.ncbi.nlm.nih.gov/29523633. https://doi.org/10.1530/EJE-17-1058.

Lindsay JR, Nieman LK. The hypothalamic-pituitary-adrenal axis in pregnancy: Challenges in disease detection and treatment. Endocr Rev. 2005;26(6):775–99. https://pubmed.ncbi.nlm.nih.gov/15827110. https://doi.org/10.1210/er.2004-0025.

Arnaldi G, Angeli A, Atkinson AB, et al. Diagnosis and complications of Cushing’s syndrome: A consensus statement. J Clin Endocrinol Metab. 2003;88(12):5593-602. https://doi.org/10.1210/jc.2003-030871.

Johnston PC, Atkinson AB, Moore MJ, et al. An unusual cause of reversible cardiomyopathy. Ulster Med J. 2012;81(3):134–5. https://pubmed.ncbi.nlm.nih.gov/23620612. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3632823.

Choi WJ, Jung TS, Paik WY. Cushing’s syndrome in pregnancy with a severe maternal complication: A case report. J Obstet Gynaecol Res. 2011; 37(2):163–7. https://pubmed.ncbi.nlm.nih.gov/21159041. https://doi.org/10.1111/j.1447-0756.2010.01339.x.

Kamenický P, Redheuil A, Roux C, et al. Cardiac structure and function in Cushing’s syndrome: A cardiac magnetic resonance imaging study. J Clin Endocrinol Metab. 2014;99(11):E2144–53. https://pubmed.ncbi.nlm.nih.gov/25093618. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4223435. https://doi.org/10.1210/jc.2014-1783.

Andreescu CE, Alwani RA, Hofland J, et al. Adrenal Cushing’s syndrome during pregnancy. Eur J Endocrinol. 2017:177(5): K13-20. https://pubmed.ncbi.nlm.nih.gov/28819015. https;//doi.org/10.1530/EJE-17-0263.

Published
2021-07-19
How to Cite
Anthony Bernard, D. M. A., Xin Yi, O., Veerasamy, H. L. A., Long Bidin, M. B., & Chee Keong, S. (2021). A Rare Occurrence of Premature Birth and Recurrent Acute Pulmonary Oedema in the Mother due to Cushing’s Syndrome: A Case Report. Journal of the ASEAN Federation of Endocrine Societies, 36(2). Retrieved from https://asean-endocrinejournal.org/index.php/JAFES/article/view/1057
Section
Case Reports