Management of Adrenal Tumors in Pregnancy

• Autores: Deirdre Cocks Eschler, Rachel Pessah-Pollack, Nina Kogekar
• Localización: Endocrinology and metabolism clinics of North America, ISSN 0889-8529, Vol. 44, Nº. 2, 2015 (Ejemplar dedicado a: Adrenal Cortical Neoplasia), págs. 381-397
• Idioma: inglés
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• Resumen

  • Adrenal diseases, including Cushing syndrome (CS), primary aldosteronism (PA), pheochromocytoma, and adrenocortical carcinoma, are uncommon in pregnancy; a high degree of clinical suspicion must exist. Physiologic changes to the hypothalamus-pituitary-adrenal axis in a normal pregnancy result in increased cortisol, renin, and aldosterone levels, making the diagnosis of CS and PA in pregnancy challenging. However, catecholamines are not altered in pregnancy and allow a laboratory diagnosis of pheochromocytoma that is similar to that of the nonpregnant state. Although adrenal tumors in pregnancy result in significant maternal and fetal morbidity, and sometimes mortality, early diagnosis and appropriate treatment often improve outcomes.