A successful case of Cushing's disease pregnancy treated with ketoconazole

Abstract

Purpose: The association of pregnancy and Cushing's disease (CD) is rare. Treatment of Cushing's syndrome (CS) is imperative to reduce maternal and fetal morbidity. Ketoconazole is a widely used drug for CS control when the woman is not pregnant but concerns about its teratogenicity and embryotoxicity restricted its use during pregnancy.

Methods and results: We describe a case of a CD patient managed with Ketoconazole during the first and second trimester and other cares for her metabolic CS aspects during pregnancy. She delivered a normal female baby.

Conclusions: It is supposed that even with treatment the relatively hypercortisolemic mother could protect her child from the embryotoxicity of ketoconazole as proved in rat fetuses and we suggest that ketoconazole could be an emergency pharmacological therapeutic option for CS management during pregnancy.

• Cushing’s disease
• Cushing’s syndrome
• ketoconazole
• pregnancy

Declaration of interest

The authors report no declarations of interest.

This study received financial support from FIPE (Fundo de Incentivo à Pesquisa do Hospital de Clínicas de Porto Alegre).