Cushing Syndrome Secondary to Ectopic ACTH Production in Pregnancy: A Case Report

Ectopic adrenocorticotropic hormone production is an extremely rare cause of Cushing syndrome in pregnancy and is associated with significant morbidity. A 37-year-old multiparous woman at 32 weeks’ gestation presented with hypertension, anasarca, hypokalemia, and fetal distress requiring an urgent c...

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Main Authors: Wei-She Julia Tai, Richa Parihar, Mary Ellene Boulos, Hertzel Gerstein, Meera Luthra, Ahraaz Wyne
Format: Article
Language:English
Published: American College of Physicians 2022-07-01
Series:Annals of Internal Medicine: Clinical Cases
Online Access:https://www.acpjournals.org/doi/10.7326/aimcc.2021.0238
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author Wei-She Julia Tai
Richa Parihar
Mary Ellene Boulos
Hertzel Gerstein
Meera Luthra
Ahraaz Wyne
author_facet Wei-She Julia Tai
Richa Parihar
Mary Ellene Boulos
Hertzel Gerstein
Meera Luthra
Ahraaz Wyne
author_sort Wei-She Julia Tai
collection DOAJ
description Ectopic adrenocorticotropic hormone production is an extremely rare cause of Cushing syndrome in pregnancy and is associated with significant morbidity. A 37-year-old multiparous woman at 32 weeks’ gestation presented with hypertension, anasarca, hypokalemia, and fetal distress requiring an urgent cesarean section. Her adrenocorticotropic hormone and cortisol levels were elevated, and high-dose dexamethasone failed to suppress them, suggesting ectopic adrenocorticotropic hormone production. Multimodality imaging did not identify a source, and she had urgent bilateral adrenalectomy for refractory severe hypercortisolism. Ectopic Cushing syndrome in pregnancy requires a high index of suspicion for diagnostic testing and prompt treatment to minimize maternal and fetal complications.
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institution DOAJ
issn 2767-7664
language English
publishDate 2022-07-01
publisher American College of Physicians
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series Annals of Internal Medicine: Clinical Cases
spelling doaj-art-88ff07b9281e4f35a0b221a3bce8d0cb2025-08-20T03:18:49ZengAmerican College of PhysiciansAnnals of Internal Medicine: Clinical Cases2767-76642022-07-011510.7326/aimcc.2021.0238Cushing Syndrome Secondary to Ectopic ACTH Production in Pregnancy: A Case ReportWei-She Julia Tai0Richa Parihar1Mary Ellene Boulos2Hertzel Gerstein3Meera Luthra4Ahraaz Wyne51University of Ottawa, Ottawa, Ontario, Canada2McMaster University, Hamilton, Ontario, Canada2McMaster University, Hamilton, Ontario, Canada2McMaster University, Hamilton, Ontario, Canada2McMaster University, Hamilton, Ontario, Canada2McMaster University, Hamilton, Ontario, CanadaEctopic adrenocorticotropic hormone production is an extremely rare cause of Cushing syndrome in pregnancy and is associated with significant morbidity. A 37-year-old multiparous woman at 32 weeks’ gestation presented with hypertension, anasarca, hypokalemia, and fetal distress requiring an urgent cesarean section. Her adrenocorticotropic hormone and cortisol levels were elevated, and high-dose dexamethasone failed to suppress them, suggesting ectopic adrenocorticotropic hormone production. Multimodality imaging did not identify a source, and she had urgent bilateral adrenalectomy for refractory severe hypercortisolism. Ectopic Cushing syndrome in pregnancy requires a high index of suspicion for diagnostic testing and prompt treatment to minimize maternal and fetal complications.https://www.acpjournals.org/doi/10.7326/aimcc.2021.0238
spellingShingle Wei-She Julia Tai
Richa Parihar
Mary Ellene Boulos
Hertzel Gerstein
Meera Luthra
Ahraaz Wyne
Cushing Syndrome Secondary to Ectopic ACTH Production in Pregnancy: A Case Report
Annals of Internal Medicine: Clinical Cases
title Cushing Syndrome Secondary to Ectopic ACTH Production in Pregnancy: A Case Report
title_full Cushing Syndrome Secondary to Ectopic ACTH Production in Pregnancy: A Case Report
title_fullStr Cushing Syndrome Secondary to Ectopic ACTH Production in Pregnancy: A Case Report
title_full_unstemmed Cushing Syndrome Secondary to Ectopic ACTH Production in Pregnancy: A Case Report
title_short Cushing Syndrome Secondary to Ectopic ACTH Production in Pregnancy: A Case Report
title_sort cushing syndrome secondary to ectopic acth production in pregnancy a case report
url https://www.acpjournals.org/doi/10.7326/aimcc.2021.0238
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