Cushing's Syndrome With Amelioration During Pregnancy

A 30-year-old woman was found to have Cushing's syndrome two months prior to becoming pregnant. During her pregnancy she demonstrated both clinical and biochemical amelioration of her Cushing's syndrome starting about the 21st week of gestation and continuing to the time of delivery. At 34 weeks she was delivered of a healthy, premature female infant who is now 4 years old and thriving. About 7 months postpartum the mother again demonstrated florid hypercortisolism. At surgery, bilateral adrenocortical hyperplasia was found and a total adrenalectomy was performed. Postoperatively, the patient's clinical state gradually returned to normal. She has remained well receiving conventional hormone replacement. Women with Cushing's syndrome have difficulty in conceiving and in maintaining pregnancy. To our knowledge, this is the first report of amelioration of Cushing's syndrome during pregnancy.