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05.08.2022 | Original Article

Pregnancy after pituitary surgery does not influence the recurrence of Cushing’s disease

verfasst von: Lia Mesquita Lousada, Mariuxi Jacqueline Borja Tapia, Valter Angelo Sperling Cescato, Gilberto Ochman da Silva, Nina Rosa Castro Musolino, Maria Candida Barisson Villares Fragoso, Marcello Delano Bronstein, Marcio Carlos Machado

Erschienen in: Endocrine

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Abstract

Purpose

Pregnancy is associated with the activation of the hypothalamus–pituitary–adrenal axis, which can cause a misdiagnosis of Cushing’s syndrome. The aim of this study is to evaluate the impact of pregnancy after pituitary surgery on the recurrence rate in Cushing’s disease (CD) patients.

Methods

This was a retrospective study in a tertiary center. Between 1990 and 2020, 355 CD patients underwent pituitary surgery. Of those, we included 113 female patients who were ≤ 45 years old (median age of 32 years, 14–45), PS remission, a follow-up of ≥6 months (median of 122 months, 6–402) and an available obstetric history. Recurrence was defined as the diagnosis of Cushing’s syndrome via at least two altered first-line methods. The patients were divided into two subgroups according to pregnancy: no pregnancy or pregnancy prior to CD diagnosis (NP/PP) and pregnancy after CD pituitary surgery (PA).

Results

Overall, recurrence occurred in 43 out of 113 patients (38%). A higher recurrence rate was seen in the PA subgroup (11/22, 50%), but there was no significant difference between the NP/PP subgroup (32/91, 35%). No difference in survival-free recurrence (SFR) was found between NP/PP and PA subgroups. The lower SFR was related to a higher PS plasma ACTH and normal pituitary at pathological analyses.

Conclusions

There was no difference in the recurrence rate in patients according to pregnancy history. Other studies with higher numbers of patients are needed to confirm these data.
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Metadaten
Titel
Pregnancy after pituitary surgery does not influence the recurrence of Cushing’s disease
verfasst von
Lia Mesquita Lousada
Mariuxi Jacqueline Borja Tapia
Valter Angelo Sperling Cescato
Gilberto Ochman da Silva
Nina Rosa Castro Musolino
Maria Candida Barisson Villares Fragoso
Marcello Delano Bronstein
Marcio Carlos Machado
Publikationsdatum
05.08.2022
Verlag
Springer US
Erschienen in
Endocrine
Print ISSN: 1355-008X
Elektronische ISSN: 1559-0100
DOI
https://doi.org/10.1007/s12020-022-03151-3

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