妊娠期尿崩症合并库欣综合征1例。

IF 3.3 3区 医学 Q3 ENDOCRINOLOGY & METABOLISM
Shinnosuke Hata, Nobuyoshi Shinokawa, Yuki Harada, Chisato Kato, Saki Ota, Osamu Takaoka, Tsukasa Narukawa, Hiroya Iwase, Toru Tanaka
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引用次数: 0

摘要

背景:妊娠期库欣综合征(CS)是一种罕见的与显著的母胎并发症相关的疾病,包括高血压、糖尿病、先兆子痫和早产。妊娠期尿崩症(DI)是一种罕见但经常被诊断出来的疾病,其有效管理对于维持妊娠和分娩期间的孕产妇健康至关重要。本病例报告描述了妊娠期间DI和CS的罕见共存,突出了诊断和管理的独特复杂性。病例介绍:一名29岁女性,有妊娠高血压病史,在第7次妊娠期间出现严重高血压、低钾血症和多尿(6.6 L/天)。实验室结果显示皮质醇升高,促肾上腺皮质激素(ACTH)抑制,左肾上腺肿块30毫米,证实肾上腺CS。尽管补充了钾,但持续多尿和体液失衡需要在妊娠27周开始去氨加压素治疗。患者随后出现先兆子痫,在29周时接受了紧急剖宫产手术,生下了一个1197克的婴儿,出生体重很低。产后多尿症消退,出院后行左肾上腺切除术。结论:该病例说明了在妊娠期处理共存的CS和GDI的复杂性,强调了考虑其他机制的重要性,如在多尿症中皮质醇诱导的抗利尿激素抵抗。多学科方法对于优化罕见内分泌疾病的母婴结局至关重要,并有助于了解妊娠期间CS和DI的相互作用。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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

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

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

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

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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来源期刊
BMC Endocrine Disorders
BMC Endocrine Disorders ENDOCRINOLOGY & METABOLISM-
CiteScore
4.40
自引率
0.00%
发文量
280
审稿时长
>12 weeks
期刊介绍: BMC Endocrine Disorders is an open access, peer-reviewed journal that considers articles on all aspects of the prevention, diagnosis and management of endocrine disorders, as well as related molecular genetics, pathophysiology, and epidemiology.
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