Gestación y psicosis esteroidea en el curso del síndrome de Cushing

La gestacion en el curso del sindrome de Cushing es infrecuente, asi como el caso inverso; o sea, que se realice el diagnostico de sindrome de Cushing durante la gestacion. Sin embargo, es posible. Se presenta el caso clinico de una paciente femenina, de 28 anos, con un adenoma cortical de suprarrenal derecha productor de cortisol, que en el curso de su enfermedad, resulto embarazada. Se decidio interrupcion del embarazo debido al riesgo materno fetal. Durante la evolucion del sindrome de Cushing presento una psicosis esteroidea que requirio tratamiento medicamentoso. Despues de realizada la adrenalectomia, se produjo remision del cuadro clinico y bioquimico. Por tal razon, alertamos a la comunidad medica a insistir en el control preconcepcional de estas pacientes(AU) Pregnancy in the course of Cushing syndrome is not frequent, as well as the contrary case, in other words, that diagnosis of Cushing's syndrome be made during pregnancy. However, it is possible. This is a clinical case of a female patient aged 28 with a cortical adenoma of the right suprarenal gland producing cortisol, which in the course of her disease became pregnant. We decide the termination of pregnancy due to mother-fetus risk. Over the course of Cushing's syndrome there was steroid psychosis requiring drug therapy. After the adrenalectomy threw was a remission of clinical and biochemical picture. Thus, it is necessary to alert the medical community to insist in preconception control of these patients(AU)

[1]  S. Claes,et al.  [Corticosteroid-induced paranoid psychosis: case report and review of the literature]. , 2011, Tijdschrift voor psychiatrie.

[2]  A. Wieck Oestradiol and psychosis: clinical findings and biological mechanisms. , 2011, Current topics in behavioral neurosciences.

[3]  P. Hellman,et al.  Adrenocorticotropin-independent Cushing’s syndrome in pregnancy related to overexpression of adrenal luteinizing hormone/human chorionic gonadotropin receptors , 2009, Journal of endocrinological investigation.

[4]  M. J. Goñi Iriarte [Cushing's syndrome: special issues]. , 2009, Endocrinologia y nutricion : organo de la Sociedad Espanola de Endocrinologia y Nutricion.

[5]  A. Saratzis,et al.  Cushing's syndrome in pregnancy: report of a case and review of the literature. , 2007, Hormones.

[6]  C. D. de Kroon,et al.  Oligohydramnios in a pregnant woman with Cushing's syndrome caused by an adrenocortical adenoma , 2007, The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians.

[7]  J. Bostwick,et al.  Psychiatric adverse effects of corticosteroids. , 2006, Mayo Clinic proceedings.

[8]  J. Jonklaas,et al.  Cushing's syndrome during pregnancy: personal experience and review of the literature. , 2005, The Journal of clinical endocrinology and metabolism.

[9]  V. Hána,et al.  Recurrent ACTH‐independent Cushing's syndrome in multiple pregnancies and its treatment with metyrapone , 2001, Clinical endocrinology.

[10]  L. Sheeler,et al.  Cushing's syndrome and pregnancy. , 1990, American journal of obstetrics and gynecology.

[11]  D. Aron,et al.  Spontaneous resolution of Cushing's syndrome after pregnancy. , 1990, American journal of obstetrics and gynecology.