Abstract:
:Pregnancy in women with a diagnosis of Cushing' syndrome (CS) is an extremely rare event and its diagnosis and treatment are a real medical challenge. During pregnancy, the hypothalamus-pituitary-adrenal axis undergoes major changes leading to a significant increase in plasma cortisol levels throughout gestation. The difficulties in diagnosis are related to the resemblance of symptoms of CS and those of pregnancy, and to the complex interpretation of the screening tests. Moreover, the diagnostic work up in the postnatal period may be difficult in the first weeks postpartum. Importantly, the etiology of CS in pregnancy differs from non-pregnant status. In pregnancy, the adrenal origin is the most frequent in up to 60% of the cases, in contrast to ACTH-secreting corticotroph adenomas of the pituitary gland, which account for 70% of the cases outside pregnancy. Nevertheless, maternal and fetal outcomes are severely affected in the context of CS whichever the etiology is, with high rates of maternal and fetal morbimortality, and with a rate of overall fetal loss of about 25% of the pregnancies. There is no consensus as to the most effective treatment in these circumstances in terms of improving maternal and fetal outcomes, as there are no studies comparing the different modalities of treatment for CS in pregnancy. However, evidence suggests that patients receiving treatment during pregnancy achieve better fetal outcomes than those who do not receive treatment. We aim to summarize in this review the major diagnostic and management difficulties during pregnancy.
journal_name
Minerva Endocrinoljournal_title
Minerva endocrinologicaauthors
Caimari F,Corcoy R,Webb SMdoi
10.23736/S0391-1977.18.02803-1subject
Has Abstractpub_date
2018-12-01 00:00:00pages
435-445issue
4eissn
0391-1977issn
1827-1634pii
S0391-1977.18.02803-1journal_volume
43pub_type
杂志文章,评审abstract::The desire to reproduce is a base human instinct. However, for many individuals, the chances of being able to have a genetic child are compromised by a number of factors. For some, therapies aimed at treating serious medical illness, such as cancer; result in a deleterious impact on the function of eggs and sperm in t...
journal_title:Minerva endocrinologica
pub_type: 杂志文章,评审
doi:10.23736/S0391-1977.17.02666-9
更新日期:2018-03-01 00:00:00
abstract::Steroid hormones mediate pleiotropic cellular processes involved in metabolism, cellular proliferation, and differentiation. The ability of the cell to respond to its hormonal environment is transduced by nuclear receptors (NRs) that bind both hormone and DNA. Hence, NRs represent a link between the external hormonal ...
journal_title:Minerva endocrinologica
pub_type: 杂志文章,评审
doi:
更新日期:2002-03-01 00:00:00
abstract::The present paper reports our personal data on gonadotropin therapy in patients with idiopathic secretory oligozoospermia due to a low biological activity of LH. In recent years the use of more specific diagnostic procedures, particularly the biological assay of gonadotropins, and a better knowledge of the biological ...
journal_title:Minerva endocrinologica
pub_type: 杂志文章,评审
doi:
更新日期:1990-01-01 00:00:00
abstract::We investigated the beta-pancreatic function in response to a standard oral glucose tolerance test (OGTT) and a tolbutamide test in a group of GH-deficient adult subjects and in a group of control subjects. Fasting plasma glucose levels were normal in all subjects; the insulin levels, basal (0.19 +/- 0.02 vs 0.99 +/- ...
journal_title:Minerva endocrinologica
pub_type: 杂志文章
doi:
更新日期:1990-04-01 00:00:00
abstract::Adrenal scintigraphy using 131I-6-beta-iodomethyl-19-norcholesterol or 6-methyl-75Se-methyl-19-norcholesterol is a function-dependent imaging method which, in association with high-resolution spatial imaging techniques, plays an essential role in the study of adrenocortical hyperfunction. It can distinguish between bi...
journal_title:Minerva endocrinologica
pub_type: 杂志文章,评审
doi:
更新日期:1995-03-01 00:00:00
abstract::In 51 patients with gastric adenocarcinoma the fasting blood concentrations of hCG, beta hCG, alpha subunits, ADH, calcitonin, enteroglucagon, gastrin, GH, melatonin, somatostatin, estradiol, CEA and pepsinogen I in the peripheral vein were estimated by radioimmunoassay at the time of diagnosis and, in those who under...
journal_title:Minerva endocrinologica
pub_type: 杂志文章
doi:
更新日期:1991-07-01 00:00:00
abstract::Medullary thyroid carcinoma arises from the C cells, which produce a characteristic hormone, calcitonin. At present, surgery is the main treatment modality. Medullary thyroid carcinoma is usually treated with total thyroidectomy and with removal of nodes in the central portion of the neck and upper mediastinum. Cervic...
journal_title:Minerva endocrinologica
pub_type: 杂志文章,评审
doi:
更新日期:1998-12-01 00:00:00
abstract::Recent trials have reported sodium-glucose co-transporter 2 (SGLT2) inhibitors to decrease cardiac morbidity and hospitalization in diabetic patients. They have a remarkable ability to modify the cardio-renal axis and have a safer metabolic profile among the existing pharmacotherapy in diabetes. There are multiple pro...
journal_title:Minerva endocrinologica
pub_type: 杂志文章
doi:10.23736/S0391-1977.20.03221-6
更新日期:2020-12-17 00:00:00
abstract::The Authors report a case of left adrenal mass incidentally discovered by upper abdominal echogram in a 40 year old man. Physical examination showed no signs of hypercortisolism and plasma cortisol and ACTH levels were in the normal range as well as urinary free cortisol. After adrenalectomy, 4 and 8 month follow-up w...
journal_title:Minerva endocrinologica
pub_type: 杂志文章
doi:
更新日期:1991-10-01 00:00:00
abstract:: ...
journal_title:Minerva endocrinologica
pub_type: 杂志文章
doi:10.23736/S0391-1977.18.02852-3
更新日期:2019-03-01 00:00:00
abstract::Acromegaly is a rare and chronic disease that, in the majority of cases, is due to the presence of a benign growth hormone (GH)-producing tumor of the pituitary. In the past, the diagnosis of acromegaly was established basically on physical changes, and only the patients with a severe clinical picture were brought to ...
journal_title:Minerva endocrinologica
pub_type: 杂志文章,评审
doi:
更新日期:2004-12-01 00:00:00
abstract::The normal growth and development of the prostate requires the presence and action of androgens, which are also known risk factors in the origins of benign and malignant prostate disease. Paradoxically, the incidence of prostate disease increases with age when serum androgen levels are in decline and emerging evidence...
journal_title:Minerva endocrinologica
pub_type: 杂志文章,评审
doi:
更新日期:2006-03-01 00:00:00
abstract::Very-low-calorie ketogenic diet (VLCKD) is a promising lifestyle intervention for the management of overweight and obesity. It is characterized by a restriction of both calories and carbohydrates, while assuring the adequate proteins, fats and micronutrients intake. Significant results in terms of excess body weight l...
journal_title:Minerva endocrinologica
pub_type: 杂志文章
doi:10.23736/S0391-1977.20.03356-8
更新日期:2020-11-19 00:00:00
abstract::Central adrenal insufficiency (AI) represents a life-threatening disorder that results from a reduced cortisol production due to an impairment production of adrenocorticotropic hormone (ACTH). In particular, secondary AI results from pituitary disease that impedes the release of ACTH, while tertiary AI is caused from ...
journal_title:Minerva endocrinologica
pub_type: 杂志文章,评审
doi:10.23736/S0391-1977.17.02701-8
更新日期:2018-06-01 00:00:00
abstract::We treated with PEI 81 patients carriers of autonomous thyroid nodule, 65 toxic and 16 non toxic, all with undetectable serum TSH and suppressed extranodular tissue on scintigraphy. The treatment schedule was: 1-2 sessions per week, 1-8 ml per session, 3-13 sessions in total, In relation to the size and the therapeuti...
journal_title:Minerva endocrinologica
pub_type: 杂志文章
doi:
更新日期:1993-12-01 00:00:00
abstract::Congenital hypogonadotropic hypogonadism (CHH) is a rare disease characterized by delayed/absent puberty and infertility due to an inadequate secretion or action of gonadotrophin-releasing hormone (GnRH), with an otherwise structurally and functionally normal hypothalamic-pituitary-gonadal (HPG) axis. CHH is genetical...
journal_title:Minerva endocrinologica
pub_type: 杂志文章,评审
doi:
更新日期:2016-06-01 00:00:00
abstract:AIM:An association between Glucagon-Like Peptide-1 Receptor Agonists (GLP1-RA) and risk of pancreatitis and pancreatic cancer has been suggested. Since its first description, several new trials (including three cardiovascular outcome trials) have been published, substantially increasing the available data set. This sug...
journal_title:Minerva endocrinologica
pub_type: 杂志文章
doi:10.23736/S0391-1977.20.03219-8
更新日期:2020-07-23 00:00:00
abstract:BACKGROUND:A limited number of human and animal studies suggest that a relationship exists between phthalates and obesity, although this is not supported by all research. The purpose of this study was to investigate the relationship between Body Mass Index (BMI) and the levels of phthalates in human blood and urine sam...
journal_title:Minerva endocrinologica
pub_type: 杂志文章
doi:10.23736/S0391-1977.16.02295-1
更新日期:2017-03-01 00:00:00
abstract::The treatment of NIDDM patients with secondary failure to sulfonylureas is still a debated problem. In this study we compared in NIDDM patients with secondary failure to glyburide, the effect of adding a single, low-dose bed time either NPH or ultralent insulin injection (0.15-0.2 U/kg) to the previously ineffective s...
journal_title:Minerva endocrinologica
pub_type: 临床试验,杂志文章,随机对照试验
doi:
更新日期:1996-06-01 00:00:00
abstract::The coexistence of Graves' disease and insulin-dependent diabetes mellitus is well known among autoimmune polyglandular syndromes and sustained by common underlying immune pathogenic factors. Hyperthyroidism itself may lead to impaired glucose tolerance in subjects with intact beta-cell function through various not we...
journal_title:Minerva endocrinologica
pub_type: 杂志文章
doi:
更新日期:1992-04-01 00:00:00
abstract::The characterisation of adrenal lesions is a common radiological dilemma. Incidental adrenal lesions are commonly detected with computed tomography (CT), and lesion characterisation is critical. The prevalence of incidental adrenal lesions has been reported to be 2.3% at autopsy and 0.5-2% with abdominal CT. Such lesi...
journal_title:Minerva endocrinologica
pub_type: 杂志文章,评审
doi:
更新日期:2009-06-01 00:00:00
abstract:BACKGROUND:Mild hypothyroidism (thyroid stimulating hormone [TSH] less than 10 mIU/L) induces reversible cognitive dysfunction, which can be evaluated by event related potentials (ERP). So far, only little is known about the impact of subclinical hypothyroidism on ERP as electrophysiological markers of cognitive activi...
journal_title:Minerva endocrinologica
pub_type: 杂志文章
doi:10.23736/S0391-1977.16.02327-0
更新日期:2017-03-01 00:00:00
abstract::A 54-year-old woman presented with an expansive mass in the anterior cervical region (front of the neck) with abscess. Laboratory tests and thyroid profile proved normal. Surgical exploration revealed a hydatid cyst in the left lobe of the thyroid gland with parasitic metastasis of the left lateral cervical lymph node...
journal_title:Minerva endocrinologica
pub_type: 杂志文章
doi:
更新日期:1999-06-01 00:00:00
abstract::A 49 year-old woman with anaplastic thyroid carcinoma came, for the first time, to our clinic with an enlarged supraclavicular lymph node. Ten years earlier she received a diagnosis of benign nodular goiter and has been followed up with ultrasonography, which never demonstrated any enlargement of her thyroid nodule an...
journal_title:Minerva endocrinologica
pub_type: 杂志文章
doi:
更新日期:2000-09-01 00:00:00
abstract:AIM:The efficacy of low and high fixed dose radioactive iodine (RAI) therapy in patients with toxic nodular goiter was investigated. METHODS:Ninety-three patients (25 males, 68 females) were included into the study (32 patients with toxic adenoma, 61 patients with toxic multinodular goiter). Patients were treated with...
journal_title:Minerva endocrinologica
pub_type: 杂志文章
doi:
更新日期:2011-06-01 00:00:00
abstract::Primary hyperparathyroidism is a not uncommon disease in the elderly. A prevalence of 3% for women and 1% for men is reported in subjects aged 65 years and over. Routine serum calcium determination and parathyroid hormone radioimmuno-assay allow to make an early diagnosis in still asymptomatic subjects. In the elderly...
journal_title:Minerva endocrinologica
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract::Diabetes mellitus (DM) is a group of metabolic disorders of carbohydrate metabolism in which glucose is underutilized, resulting in hyperglycemia. Reproductive impairment in poorly controlled diabetes mellitus type 1 (T1DM) results from a combined effect of insulin deficiency and hyperglycemia that disrupt the functio...
journal_title:Minerva endocrinologica
pub_type: 杂志文章,评审
doi:10.23736/S0391-1977.16.02477-9
更新日期:2017-09-01 00:00:00
abstract::According to the literature, the prevalence of papillary thyroid microcarcinoma (PTMC) is increasing. To date, PMTC account for up to 30% of all differentiated thyroid cancers. Patients with PTMC have an excellent prognosis with a normal life expectancy. Because of the differential definitions of the PTMC, the therape...
journal_title:Minerva endocrinologica
pub_type: 杂志文章,评审
doi:
更新日期:2009-03-01 00:00:00
abstract:BACKGROUND:The aim of this study was to evaluate long-term effectiveness and safety of liraglutide in real world. METHODS:A diabetes clinic in Italy systematically collected data of all patients treated with liraglutide. Generalized hierarchical linear regression models for repeated measures were applied to assess tre...
journal_title:Minerva endocrinologica
pub_type: 杂志文章
doi:
更新日期:2016-03-01 00:00:00
abstract::Neuroendocrine tumours (NET) are relatively rare neoplasms affecting principally the gastroenteropancreatic tract, but with potential ubiquitary location, as the neural crest cells, origin of this group of tumours, are dispersed in various organs and tissues. After the discovery of somatostatin receptors (SSTR) over-e...
journal_title:Minerva endocrinologica
pub_type: 杂志文章,评审
doi:
更新日期:2008-09-01 00:00:00