PMID: 11910875Mar 26, 2002Paper

Manifestation of Cushing syndrome and osteoporotic fractures in pregnancy in a patient with Carney complex

Medizinische Klinik
K ReschkeHendrik Lehnert

Abstract

In a 31-year-old patient a conventional X-ray was performed due to persistent pain at the lumbar spine level after a cesarean section. It revealed compression fractures of L2 and L3. Besides very clear clinical signs of hypercortisolism, multiple hyperpigmentations and naevi in the patient's face including the lips and the conjunctiva of the right eye were visible, suggesting a Carney complex. Insuppressible cortisol levels confirmed an adrenal origin of hypercortisolism. A selective catheterization of adrenal veins supported the presence of bilateral adrenal cortisol production. The computed tomography showed nodular lesions in the right and a hyperplasia of the left adrenal gland. A bilateral adrenalectomy was performed and a primary pigmented nodular adrenal hyperplasia was confirmed histologically. Clinical signs of hypercortisolism rapidly resolved after adrenalectomy. The diagnosis of Cushing's syndrome as a part of Carney complex was diagnosed at the end of a pregnancy although signs of hypercortisolism were present a long time before. The rare diagnosis of Carney complex should be considered in patients exhibiting symptoms of hypercortisolim and the typical clinical signs (hyperpigmentations).

Citations

Mar 14, 2003·Current Opinion in Obstetrics & Gynecology·Edwin Chandraharan, Sabaratnam Arulkumaran
May 28, 2020·Frontiers in Endocrinology·Damian J RalserAnke Paschkowiak-Christes
Apr 14, 2005·Endocrine Reviews·John R Lindsay, Lynnette K Nieman
Nov 26, 2011·Best Practice & Research. Clinical Endocrinology & Metabolism·Oksana Lekarev, Maria I New

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