The hypothalamus-pituitary-adrenal axis is known to become active during pregnancy, leading to a false-positive diagnosis of Cushing’s disease. For a study, researchers to assess how Cushing’s disease (CD) patients’ recurrence rates are affected by pregnancy following pituitary surgery.
In a tertiary facility, this study was retrospective in nature. About 355 CD patients underwent pituitary surgery between 1990 and 2020. Of those, 113 female patients with PS remission, a follow-up of fewer than six months (median of 122 months, 6-402), and an accessible obstetric history were included (median age, 32 years, 14–45). The diagnosis of Cushing’s syndrome using at least two modified first-line techniques was used to determine recurrence. Pregnancy status was used to separate the patients into two subgroups: no pregnancy or pregnancy before CD diagnosis (NP/PP) and pregnancy following CD pituitary surgery (PA).
Recurrence happened in 43 out of 113 patients overall (38%). The PA grouping had a higher recurrence rate (11/22, 50%), but there was no discernible difference between the NP/PP subgroup (32/91, 35%). In addition, there was no discernible difference in survival-free recurrence (SFR) between the NP/PP and PA subgroups. In pathological studies, the lower SFR was associated with a greater PS plasma ACTH and a normal pituitary.
Based on previous pregnancies, there was no difference in the recurrence rate across patients. However, more investigations with larger patient populations are required to verify these findings.
Reference: link.springer.com/article/10.1007/s12020-022-03151-3
