Cushing’s syndrome with diabetes insipidus in pregnancy: a case report

Abstract Background Cushing’s syndrome (CS) during pregnancy is a rare condition associated with significant maternal and fetal complications, including hypertension, diabetes, preeclampsia, and preterm birth. Diabetes insipidus (DI) in pregnancy is a rare but often diagnosed condition, and its effe...

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Main Authors: Shinnosuke Hata, Nobuyoshi Shinokawa, Yuki Harada, Chisato Kato, Saki Ota, Osamu Takaoka, Tsukasa Narukawa, Hiroya Iwase, Toru Tanaka
Format: Article
Language:English
Published: BMC 2025-08-01
Series:BMC Endocrine Disorders
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Online Access:https://doi.org/10.1186/s12902-025-01946-9
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author Shinnosuke Hata
Nobuyoshi Shinokawa
Yuki Harada
Chisato Kato
Saki Ota
Osamu Takaoka
Tsukasa Narukawa
Hiroya Iwase
Toru Tanaka
author_facet Shinnosuke Hata
Nobuyoshi Shinokawa
Yuki Harada
Chisato Kato
Saki Ota
Osamu Takaoka
Tsukasa Narukawa
Hiroya Iwase
Toru Tanaka
author_sort Shinnosuke Hata
collection DOAJ
description Abstract Background Cushing’s syndrome (CS) during pregnancy is a rare condition associated with significant maternal and fetal complications, including hypertension, diabetes, preeclampsia, and preterm birth. Diabetes insipidus (DI) in pregnancy is a rare but often diagnosed condition, and its effective management is crucial for maintaining maternal health during pregnancy and childbirth. This case report describes the rare coexistence of DI and CS during pregnancy, highlighting the unique complexities in diagnosis and management. Case presentation A 29-year-old woman with a history of pregnancy-induced hypertension developed severe hypertension, hypokalemia, and polyuria (6.6 L/day) during her 7th pregnancy. Laboratory findings showed elevated cortisol, suppressed adrenocorticotropic hormone (ACTH), and a 30-mm left adrenal mass, confirming adrenal CS. Despite potassium supplementation, persistent polyuria and fluid imbalance necessitated initiating desmopressin therapy at 27 weeks of gestation. The patient subsequently developed preeclampsia and underwent emergency cesarean section at 29 weeks, delivering a 1197-g infant with a very low birth weight. Polyuria resolved postpartum, and she underwent left adrenalectomy after discharge. Conclusions This case illustrates the complexity of managing coexisting CS and GDI during pregnancy, emphasizing the importance of considering alternative mechanisms, such as cortisol-induced antidiuretic hormone resistance, in polyuria. Multidisciplinary approaches are crucial to optimizing maternal and fetal outcomes in rare endocrine conditions, and help contribute to the understanding of CS and DI interactions during pregnancy.
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spelling doaj-art-b066738f766c4ba0bb9c2d269cd343782025-08-24T11:34:17ZengBMCBMC Endocrine Disorders1472-68232025-08-012511810.1186/s12902-025-01946-9Cushing’s syndrome with diabetes insipidus in pregnancy: a case reportShinnosuke Hata0Nobuyoshi Shinokawa1Yuki Harada2Chisato Kato3Saki Ota4Osamu Takaoka5Tsukasa Narukawa6Hiroya Iwase7Toru Tanaka8Department of Endocrinology and Metabolism, Japanese Red Cross Society Kyoto Daiichi HospitalDepartment of Endocrinology and Metabolism, Japanese Red Cross Society Kyoto Daiichi HospitalDepartment of Endocrinology and Metabolism, Japanese Red Cross Society Kyoto Daiichi HospitalDepartment of Endocrinology and Metabolism, Japanese Red Cross Society Kyoto Daiichi HospitalDepartment of Obstetrics and Gynecology, Japanese Red Cross Society Kyoto Daiichi HospitalDepartment of Obstetrics and Gynecology, Japanese Red Cross Society Kyoto Daiichi HospitalDepartment of Urology, Japanese Red Cross Society Kyoto Daiichi HospitalDepartment of Endocrinology and Metabolism, Japanese Red Cross Society Kyoto Daiichi HospitalDepartment of Endocrinology and Metabolism, Japanese Red Cross Society Kyoto Daiichi HospitalAbstract Background Cushing’s syndrome (CS) during pregnancy is a rare condition associated with significant maternal and fetal complications, including hypertension, diabetes, preeclampsia, and preterm birth. Diabetes insipidus (DI) in pregnancy is a rare but often diagnosed condition, and its effective management is crucial for maintaining maternal health during pregnancy and childbirth. This case report describes the rare coexistence of DI and CS during pregnancy, highlighting the unique complexities in diagnosis and management. Case presentation A 29-year-old woman with a history of pregnancy-induced hypertension developed severe hypertension, hypokalemia, and polyuria (6.6 L/day) during her 7th pregnancy. Laboratory findings showed elevated cortisol, suppressed adrenocorticotropic hormone (ACTH), and a 30-mm left adrenal mass, confirming adrenal CS. Despite potassium supplementation, persistent polyuria and fluid imbalance necessitated initiating desmopressin therapy at 27 weeks of gestation. The patient subsequently developed preeclampsia and underwent emergency cesarean section at 29 weeks, delivering a 1197-g infant with a very low birth weight. Polyuria resolved postpartum, and she underwent left adrenalectomy after discharge. Conclusions This case illustrates the complexity of managing coexisting CS and GDI during pregnancy, emphasizing the importance of considering alternative mechanisms, such as cortisol-induced antidiuretic hormone resistance, in polyuria. Multidisciplinary approaches are crucial to optimizing maternal and fetal outcomes in rare endocrine conditions, and help contribute to the understanding of CS and DI interactions during pregnancy.https://doi.org/10.1186/s12902-025-01946-9Diabetes insipidusArginine vasopressinAVPCushing’s syndrome
spellingShingle Shinnosuke Hata
Nobuyoshi Shinokawa
Yuki Harada
Chisato Kato
Saki Ota
Osamu Takaoka
Tsukasa Narukawa
Hiroya Iwase
Toru Tanaka
Cushing’s syndrome with diabetes insipidus in pregnancy: a case report
BMC Endocrine Disorders
Diabetes insipidus
Arginine vasopressin
AVP
Cushing’s syndrome
title Cushing’s syndrome with diabetes insipidus in pregnancy: a case report
title_full Cushing’s syndrome with diabetes insipidus in pregnancy: a case report
title_fullStr Cushing’s syndrome with diabetes insipidus in pregnancy: a case report
title_full_unstemmed Cushing’s syndrome with diabetes insipidus in pregnancy: a case report
title_short Cushing’s syndrome with diabetes insipidus in pregnancy: a case report
title_sort cushing s syndrome with diabetes insipidus in pregnancy a case report
topic Diabetes insipidus
Arginine vasopressin
AVP
Cushing’s syndrome
url https://doi.org/10.1186/s12902-025-01946-9
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