[1]吴晗,徐丹,王君,等.妊娠诱发库欣综合征的诊疗进展[J].国际内分泌代谢杂志,2024,44(01):47-50.[doi:10.3760/cma.j.cn121383-20230722-07028]
 Wu Han,Xu Dan,Wang Jun,et al.Clinical advances in pregnancy-induced Cushing's syndrome[J].International Journal of Endocrinology and Metabolism,2024,44(01):47-50.[doi:10.3760/cma.j.cn121383-20230722-07028]
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妊娠诱发库欣综合征的诊疗进展()
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《国际内分泌代谢杂志》[ISSN:1673-4157/CN:12-1383/R]

卷:
44
期数:
2024年01期
页码:
47-50
栏目:
综述
出版日期:
2024-01-20

文章信息/Info

Title:
Clinical advances in pregnancy-induced Cushing's syndrome
作者:
吴晗徐丹王君吴炎
深圳市人民医院(暨南大学第二临床医学院,南方科技大学第一附属医院)内分泌科,深圳 518020
Author(s):
Wu Han Xu Dan Wang Jun Wu Yan
Department of Endocrinology, Shenzhen People's Hospital(The Second Clinical Medical College of Jinan University, the First Affiliated Hospital of Nanfang University of Science and Technology), Shenzhen 518020, China
关键词:
库欣综合征 妊娠 肾上腺增生 促黄体生成素/绒毛膜促性腺激素受体
Keywords:
Cushing's syndrome Pregnancy Adrenal hyperplasia LHCGR
DOI:
10.3760/cma.j.cn121383-20230722-07028
摘要:
妊娠诱发库欣综合征是指妊娠状态所诱发的库欣综合征,一般患者在分娩后或终止妊娠后症状得到缓解。该病非常罕见,但对母体与胎儿均产生严重危害。妊娠诱发库欣综合征和妊娠合并库欣综合征在临床表现上相似,但在发病机制及治疗方法上存在差异,诊断较为困难,治疗面临挑战。本文主要针对妊娠诱发库欣综合征的发病机制、诊断和治疗进行简要综述,旨在为妊娠诱发库欣综合征患者的临床管理提供借鉴。
Abstract:
Pregnancy-induced Cushing's syndrome refers to Cushing's syndrome induced by the state of pregnancy. Generally, patients experience relief in symptoms after delivery or termination of pregnancy. This disease is very rare, but it can cause serious harm to both the mothers and the fetuses. The clinical manifestations of pregnancy-induced Cushing's syndrome and pregnancy with Cushing's syndrome are similar, but there are differences in pathogenesis and treatment methods, making diagnosis difficult and treatment challenging. This article mainly reviews the pathogenesis, diagnosis, and therapies of pregnancy-induced Cushing's syndrome, aiming to provide possible suggestions for the clinical management of this condition.

参考文献/References:

[1] Castinetti F,Brue T.Impact of Cushing's syndrome on fertility and pregnancy[J].Ann Endocrinol(Paris),2022,83(3):188-190.DOI:10.1016/j.ando.2022.04.001.
[2] Aron DC,Schnall AM,Sheeler LR.Spontaneous resolution of Cushing's syndrome after pregnancy[J].Am J Obstet Gynecol,1990,162(2):472-474.DOI:10.1016/0002-9378(90)90413-2.
[3] Caticha O,Odell WD,Wilson DE,et al.Estradiol stimulates cortisol production by adrenal cells in estrogen-dependent primary adrenocortical nodular dysplasia[J].J Clin Endocrinol Metab,1993,77(2):494-497.DOI:10.1210/jcem.77.2.8345057.
[4] Close CF,Mann MC,Watts JF,et al.ACTH-independent Cushing's syndrome in pregnancy with spontaneous resolution after delivery:control of the hypercortisolism with metyrapone[J].Clin Endocrinol(Oxf),1993,39(3):375-379.DOI:10.1111/j.1365-2265.1993.tb02380.x.
[5] Wallace C,Toth EL,Lewanczuk RZ,et al.Pregnancy-induced Cushing's syndrome in multiple pregnancies[J].J Clin Endocrinol Metab,1996,81(1):15-21.DOI:10.1210/jcem.81.1.8550743.
[6] Lacroix A,Hamet P,Boutin JM.Leuprolide acetate therapy in luteinizing hormone--dependent Cushing's syndrome[J].N Engl J Med,1999,341(21):1577-1581.DOI:10.1056/NEJM199911183412104.
[7] Kasperlik-Zaluska AA,Szczupacka I,Leszczynska-Bystrzanowska J,et al.Pregnancy-dependent Cushing's syndrome in three pregnancies[J].BJOG,2000,107(6):810-812.DOI:10.1111/j.1471-0528.2000.tb13348.x.
[8] Hána V,Dokoupilová M,Marek J,et al.Recurrent ACTH-independent Cushing's syndrome in multiple pregnancies and its treatment with metyrapone[J].Clin Endocrinol(Oxf),2001,54(2):277-281.DOI:10.1046/j.1365-2265.2001.01055.x.
[9] Chui MH,Ozbey NC,Ezzat S,et al.Case report:adrenal LH/hCG receptor overexpression and gene amplification causing pregnancy-induced Cushing's syndrome[J].Endocr Pathol,2009,20(4):256-261.DOI:10.1007/s12022-009-9090-2.
[10] Achong N,D'Emden M,Fagermo N,et al.Pregnancy-induced Cushing's syndrome in recurrent pregnancies:case report and literature review[J].Aust N Z J Obstet Gynaecol,2012,52(1):96-100.DOI:10.1111/j.1479-828X.2011.01388.x.
[11] 曾文衡,陈笑蟾,徐姣君.妊娠诱发库欣综合征一例报告并文献复习[J].中华妇产科杂志,2015(3):216-217.DOI:10.3760/cma.j.issn.0529-567x.2015.03.010.
[12] Li S,Yang C,Fan J,et al.Pregnancy-induced Cushing's syndrome with an adrenocortical adenoma overexpressing LH/hCG receptors:a case report[J].BMC Endocr Disord,2020,20(1):62.DOI:10.1186/s12902-020-0539-0.
[13] Andreescu CE,Alwani RA,Hofland J,et al.Adrenal Cushing's syndrome during pregnancy[J].Eur J Endocrinol,2017,177(5):K13-K20.DOI:10.1530/EJE-17-0263.
[14] Plöckinger U,Chrusciel M,Doroszko M,et al.Functional implications of LH/hCG receptors in pregnancy-induced Cushing syndrome[J].J Endocr Soc,2017,1(1):57-71.DOI:10.1210/js.2016-1021.
[15] Younes N,St-Jean M,Bourdeau I,et al.Endogenous Cushing's syndrome during pregnancy[J].Rev Endocr Metab Disord,2023,24(1):23-38.DOI:10.1007/s11154-022-09731-y.
[16] Hamblin R,Coulden A,Fountas A,et al.The diagnosis and management of Cushing's syndrome in pregnancy[J].J Neuroendocrinol,2022,34(8):e13118.DOI:10.1111/jne.13118.
[17] Caimari F,Valassi E,Garbayo P,et al.Cushing's syndrome and pregnancy outcomes:a systematic review of published cases[J].Endocrine,2017,55(2):555-563.DOI:10.1007/s12020-016-1117-0.
[18] Kyriakos G,Farmaki P,Voutyritsa E,et al.Cushing's syndrome in pregnancy:a review of reported cases[J].Endokrynol Pol,2021,72(1):64-72.DOI:10.5603/EP.a2020.0089.
[19] Yin X,Liu J.Estrogen receptor α plays an important role in Cushing's syndrome during pregnancy[J].Med Hypotheses,2020,143:109817.DOI:10.1016/j.mehy. 2020.109817.
[20] Bernichtein S,Alevizaki M,Huhtaniemi I.Is the adrenal cortex a target for gonadotropins?[J].Trends Endocrinol Metab,2008,19(7):231-238.DOI:10.1016/j.tem.2008.06.003.
[21] Kersten M,Hancke K,Janni W,et al.Pregnancy induced Cushing's syndrome and primary aldosteronism:a case report[J].BMC Pregnancy Childbirth,2020,20(1):421.DOI:10.1186/s12884-020-03117-1.
[22] St-Jean M,MacKenzie-Feder J,Bourdeau I,et al.Exacerbation of Cushing's syndrome during pregnancy:stimulation of a cortisol-secreting adrenocortical adenoma by ACTH originating from the foeto-placental unit[J].Endocrinol Diabetes Metab Case Rep,2019,2019:18-0115.DOI:10.1530/EDM-18-0115.
[23] Machado MC,Fragoso MCBV,Bronstein MD.Pregnancy in Patients with Cushing's Syndrome[J].Endocrinol Metab Clin North Am,2018,47(2):441-449.DOI:10.1016/j.ecl.2018.02.004.
[24] 安平,陈康,母义明.妊娠女性库欣综合征的临床诊治[J].中华内分泌代谢杂志,2020,36(2):180-184.DOI:10.3760/cma.j.issn.1000-6699.2020.02.017.
[25] Brue T,Amodru V,Castinetti F.Management of endocrine disease:management of cushing's syndrome during pregnancy:solved and unsolved questions[J].Eur J Endocrinol,2018,178(6):R259-R266.DOI:10.1530/EJE-17-1058.
[26] Martínez García R,Martínez Pérez A,Domingo del Pozo C,et al.Cushing's syndrome in pregnancy.Laparoscopic adrenalectomy during pregnancy:the mainstay treatment[J].J Endocrinol Invest,2016,39(3):273-276.DOI:10.1007/s40618-015-0345-0.
[27] Lin W,Huang HB,Wen JP,et al.Approach to Cushing's syndrome in pregnancy:two cases of Cushing's syndrome in pregnancy and a review of the literature[J].Ann Transl Med,2019,7(18):490.DOI:10.21037/atm.2019.07.94.
[28] Lim WH,Torpy DJ,Jeffries WS.The medical management of Cushing's syndrome during pregnancy[J].Eur J Obstet Gynecol Reprod Biol,2013,168(1):1-6.DOI:10.1016/j.ejogrb.2012.12.015.

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备注/Memo

备注/Memo:
基金项目:国家自然科学青年基金(82000768); 深圳市科技计划项目基础研究面上项目(JCYJ20220530152813030)
通信作者:吴炎,Email:wuyan3@medmail.com.cn
更新日期/Last Update: 2024-03-20