Periodic Secretion of Adrenocorticotropin in a Patient with Cushing's Disease Manifested during Pregnancy

• MIYOSHI Tomoko

  Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• OTSUKA Fumio

  Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• SUZUKI Jiro

  Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• INAGAKI Kenichi

  Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• TAKEDA Masaya

  Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• KANO Yoshihiro

  Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• YAMASHITA Tetsuji

  Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• OGURA Toshio

  Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• DATE Isao

  Department of Neurosurgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

• TANAKA Yasushi

  Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University

• HASHIMOTO Kozo

  Department of Endocrinology, Metabolism and Nephrology, Kochi Medical School, Kochi University

• MAKINO Hirofumi

  Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

抄録

We report the case of 19-year-old woman with cyclical Cushing's disease, in whom plasma adrenocorticotropin (ACTH) was secreted periodically after her first pregnancy. Since the 33rd week of pregnancy, hypertension and proteinuria became clinically remarkable. She gave normal birth at 36th week of pregnancy; however she continued to gain body weight even after delivery and developed typical Cushingoid features. Her ACTH secretion lacked normal daily fluctuation but exhibited periodic change during 1-year observation, showing 119 pg/ml, 34.6 pg/ml and 115 pg/ml at the 4th, 7th and 13th months after delivery. Plasma ACTH levels were increased by corticotropin releasing hormone and metyrapone, while low-dose dexamethasone suppressed cortisol secretion. Gel filtration analysis of the patient's plasma detected big ACTH molecules being eluted with a peak of authentic 1–39 ACTH. Cranial magnetic resonance imaging revealed a 1-cm pituitary mass in right cavernous sinus. The pituitary tumor was removed by transsphenoidal surgery at 13th month after delivery and was pathologically compatible with ACTH-producing pituitary adenoma by immunohistochemistry. This case includes clinically rare subsets of Cushing's syndrome showing periodic ACTH secretion and aberrant ACTH molecules.<br>

収録刊行物

• Endocrine Journal

  Endocrine Journal 52 (3), 287-292, 2005

  一般社団法人 日本内分泌学会

キーワード

• Adrenocorticotropin (ACTH)
• Big ACTH
• Cyclical Cushing's syndrome
• Gel filtration analysis
• Pituitary adenoma
• Pregnancy

詳細情報

• CRID: 1390001206298228864
• NII論文ID: 10016565507
• NII書誌ID: AA10901436
• DOI: 10.1507/endocrj.52.287
• COI: 1:STN:280:DC%2BD2Mzlt1Ojug%3D%3D
• ISSN: 13484540
• ISSN: 09188959
• PubMed: 16006722
• Web Site: http://www.jstage.jst.go.jp/article/endocrj/52/3/52_3_287/_pdf
• Web Site: https://search.jamas.or.jp/link/ui/2006014921
• 本文言語コード: en
• データソース種別:
  • JaLC
  • Crossref
  • PubMed
  • CiNii Articles
• 抄録ライセンスフラグ: 使用不可