A successful pregnancy in a patient with secondary hypertension caused by adrenal adenoma: a case report

• Published in: BMC pregnancy and childbirth 2019-04, Vol.19 (1), p.116-116, Article 116
• Main Authors: Zhang, Xin, Liao, Hang, Zhu, Xiaojiang, Shi, Di, Chen, Xiaoping
• Format: Article
• Language: English
• Subjects: Adrenal adenoma; Adrenal glands; Antihypertensives; Blood pressure; Case Report; Case reports; Clinical medicine; Cushing syndrome; Cushing’s syndrome; Cysts; Diabetes; Edema; Family medical history; Hormones; Hypertension; Kidney diseases; Laparoscopy; Neuroendocrine tumors; NMR; Nuclear magnetic resonance; Preeclampsia; Pregnancy; Tumors; Ultrasonic imaging; Urine
• ISSN: 1471-2393; 1471-2393
• DOI: 10.1186/s12884-019-2262-2

Secondary hypertension is a rare complication in pregnancy that causes poor outcomes, such as preeclampsia, premature delivery, intrauterine growth retardation, stillbirths, spontaneous abortion or intrauterine death. Cushing's disease caused by an adrenal adenoma is rare during pregnancy and may be overlooked by obstetricians and physicians, but can lead to hypertension, diabetes mellitus and an increased risk of fetal and maternal morbidity. Approximately 200 cases have been reported in the literature. Here, we report the successful management of a pregnant patient with Cushing's syndrome due to an adrenal adenoma. The 35-year-old Chinese female had no individual or family medical history of hypertension, and did not exhibit chronic kidney disease, diabetes mellitus, autoimmune and common endocrine diseases. Her blood pressure was elevated from the 16th week of gestation and was not controlled by 30 mg nifedipine twice a day. Examination in our department revealed her 24 h urinary free cortisol (24 h UFC) level was 1684.3 μg/24 h (normal range: 20.26-127.55 μg/24 h) and plasma adrenocorticotropic hormone was