Infertility as the onset of Cushing’s disease: is pasireotide a treatment option?

Open access

ABSTRACT

Introduction Cushing’s disease is a complex endocrine disorder characterized by excessive glucocorticoid secretion caused by an ACTH-secreting pituitary adenoma. Hyperandrogenism and menstrual disorders such as amenorrhea and oligomenorrhea complete the clinical picture of Cushing’s syndrome. Infertility is relatively common, involving complex pathogenetic mechanisms, which differ depending on the cause of hypercortisolism.

Case presentation We present the case of a female patient diagnosed with Cushing’s disease during the investigations carried out to assess infertility. After transsphenoidal adenomectomy, the patient underwent treatment with pasireotide and dopamine agonists, achieving normalization of gonadotropin and estradiol levels.

Conclusion Current guidelines recommended transsphenoidal adenomectomy as first-line therapy in an attempt to correct hypercortisolism and restore fertility in patients with Cushing’s disease. In case of relapse pasireotide and dopamine agonists can be effective in normalizing the hormonal profile

References

  • 1. Pivonello, R., De Martino, M. C., De Leo, M., Lombardi, G., & Colao, A. (2008). Cushing’s Syndrome. Endocrinol Metab Clin North Am, 37(1), 135-149, ix. doi: 10.1016/j. ecl.2007.10.010

  • 2. Shah, D. & Patel, S. (2009). Hirsutism. Gynecol Endocrinol, 25 (3),140-148.

  • 3. Sharma, J.B., Roy, K.K., Mohanraj, P., Kumar ,S., Karmakar, D. & Barua, J. (2009). Pregnancy outcome in pituitary tumors. Arch Gynecol Obstet. 280 (3),401-404.

  • 4. Poullot, A-G. & Chevalier, N. (2013). New options in the treatment of Cushing’s disease: a focus on pasireotide. Research and Reports in Endocrine Disorders. 3,31-38.

  • 5. Aron, D.C., Schnall, A.M. & Sheeler, L.R. Cushing’s syndrome and pregnancy. Am J Obstetrics and gynecology, 162 (1),244-252.

  • 6. Ursula, B. (2012). Hyperprolactinemia and infertility: new insight. J Clin Invest. 122 (10), 3791-3795.

  • 7. Gadelha, M.R., Viera Neto, L. (2014). Efficacy of medical treatment in Cushing’s disease: a systeamtic review, Clin Endocrinol (Oxf). 80 (1):1-12

  • 8. Bertagna, X & Guignat, L. (2013). Approach to the Cushing's disease patient with persistent/ recurrent hypercortisolism after pituitary surgery. J Clin Endocrinol Metab. 98(4):1307-18. doi: 10.1210/jc.2012-3200.

ARS Medica Tomitana

The Journal of "Ovidius" University of Constanta

Journal Information

Metrics

All Time Past Year Past 30 Days
Abstract Views 0 0 0
Full Text Views 19 19 13
PDF Downloads 2 2 1