Adrenal disorders in pregnancy

Nature Reviews Endocrinology

Volumn 8, Issue 11, 2012, Pages 668-678

  Monticone, Silvia ^a   Auchus, Richard J ^b   Rainey, William E ^a  

^a MEDICAL COLLEGE OF GEORGIA   (United States)

^b UNIVERSITY OF MICHIGAN MEDICAL SCHOOL   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

(3 IODOBENZYL)GUANIDINE I 123; 11BETA HYDROXYSTEROID DEHYDROGENASE 2; ALDOSTERONE; AMILORIDE; ANTIHYPERTENSIVE AGENT; AROMATASE; CALCIUM CHANNEL BLOCKING AGENT; CORTICOSTEROID; CORTICOTROPIN; CORTICOTROPIN RECEPTOR; CORTICOTROPIN RELEASING FACTOR; ESTROGEN; FLUDROCORTISONE ACETATE; HYDROCORTISONE; METHYLDOPA; METYRAPONE; POTASSIUM; PRASTERONE SULFATE; SPIRONOLACTONE; SULFATASE; TRIAMTERENE;

ADAPTATION; ADDISON DISEASE; ADRENAL DISEASE; ADRENAL INSUFFICIENCY; ADRENAL SCINTISCANNING; ADRENALECTOMY; ALDOSTERONE BLOOD LEVEL; COMPUTER ASSISTED TOMOGRAPHY; CONGENITAL ADRENAL HYPERPLASIA; CONSERVATIVE TREATMENT; CUSHING SYNDROME; ENZYME DEFICIENCY; FEMALE; FETAL ADRENAL HYPOPLASIA; FETOPLACENTAL UNIT; FETUS; HUMAN; HYPOPLASIA; HYPOTHALAMUS HYPOPHYSIS ADRENAL SYSTEM; LAPAROSCOPIC SURGERY; MATERNAL HYPERTENSION; MATERNAL MORBIDITY; MATERNAL MORTALITY; PHEOCHROMOCYTOMA; PLACENTA; PREGNANCY DISORDER; PRIMARY HYPERALDOSTERONISM; PRIORITY JOURNAL; REFERENCE VALUE; REVIEW; SEXUAL DEVELOPMENT; SIGNAL TRANSDUCTION; STEROID 21 MONOOXYGENASE DEFICIENCY; STEROID METABOLISM;

ADRENAL GLAND DISEASES; ADRENAL HYPERPLASIA, CONGENITAL; ANIMALS; FEMALE; FETAL DISEASES; HUMANS; PREGNANCY; PREGNANCY COMPLICATIONS;

EID: 84867690436     PISSN: 17595029     EISSN: 17595037     Source Type: Journal    
DOI: 10.1038/nrendo.2012.155     Document Type: Review

References (117)

1. Rainey, W. E., Rehman, K. S. & Carr, B. R. The human fetal adrenal: making adrenal androgens for placental estrogens. Semin. Reprod. Med. 22, 327-336 (2004). (Pubitemid 40030082)
2. Ishimoto, H. & Jaffe, R. B. Development and function of the human fetal adrenal cortex: a key component in the feto-placental unit. Endocr. Rev. 32, 317-355 (2011).
3. Diczfalusy, E. Endocrine functions of the human fetoplacental unit. Fed. Proc. 23, 791-798 (1964).
4. Lindsay, J. R. & Nieman, L. K. The hypothalamic-pituitary-adrenal axis in pregnancy: challenges in disease detection and treatment. Endocr. Rev. 26, 775-799 (2005). (Pubitemid 41428538)
5. Mesiano, S., Coulter, C. L. & Jaffe, R. B. Localization of cytochrome P450 cholesterol side-chain cleavage, cytochrome P450 17a-hydroxylase/17, 20-lyase, and 3 ß-hydroxysteroid dehydrogenase isomerase steroidogenic enzymes in human and rhesus monkey fetal adrenal glands: reappraisal of functional zonation. J. Clin. Endocrinol. Metab. 77, 1184-1189 (1993). (Pubitemid 23345467)
6. Ben-David, S. et al. Parturition itself is the basis for fetal adrenal involution. J. Clin. Endocrinol. Metab. 92, 93-97 (2007). (Pubitemid 46067513)
7. Goto, M. et al. In humans, early cortisol biosynthesis provides a mechanism to safeguard female sexual development. J. Clin. Invest. 116, 953-960 (2006).
8. Rehman, K. S., Carr, B. R. & Rainey, W. E. Profiling the steroidogenic pathway in human fetal and adult adrenals. J. Soc. Gynecol. Investig. 10, 372-380 (2003). (Pubitemid 37102847)
9. Siiteri, P. K. & MacDonald, P. C. Placental estrogen biosynthesis during human pregnancy. J. Clin. Endocrinol. Metab. 26, 751-761 (1966).
10. Bolte, E., Mancuso, S., Eriksson, G., Wiqvist, N. & Diczfalusy, E. Studies on the aromatisation of neutral steroids in pregnant women. I. Aromatisation of C-19 steroids by placentas perfused in situ. Acta Endocrinol. (Copenh.) 45, 535-559 (1964).
11. Pang, S. et al. Amniotic fluid concentrations of A5 and A4 steroids in fetuses with congenital adrenal hyperplasia due to 21 hydroxylase deficiency and in anencephalic fetuses. J. Clin. Endocrinol. Metab. 51, 223-229 (1980). (Pubitemid 10007623)
12. 5-pregnenolone. J. Clin. Endocrinol. Metab. 48, 133-138 (1979). (Pubitemid 9101623)
13. Rouse, D. J. et al. A trial of 17 α-hydroxyprogesterone caproate to prevent prematurity in twins. N. Engl. J. Med. 357, 454-461 (2007). (Pubitemid 47204874)
14. Meis, P. J. et al. Prevention of recurrent preterm delivery by 17 α-hydroxyprogesterone caproate. N. Engl. J. Med. 348, 2379-2385 (2003). (Pubitemid 36682816)
15. Bocian-Sobkowska, J., Malendowicz, L. K., Wozniak, W. & Kopaczyk, M. Adrenal glands in anencephaly. Folia Morphol. (Warsz.) 55, 214-216 (1996).
16. Parker, C. R. Jr, Stankovic, A. M. & Goland, R. S. Corticotropin-releasing hormone stimulates steroidogenesis in cultured human adrenal cells. Mol. Cell Endocrinol. 155, 19-25 (1999). (Pubitemid 29460961)
17. Sirianni, R., Rehman, K. S., Carr, B. R., Parker, C. R. Jr & Rainey, W. E. Corticotropin-releasing hormone directly stimulates cortisol and the cortisol biosynthetic pathway in human fetal adrenal cells. J. Clin. Endocrinol. Metab. 90, 279-285 (2005). (Pubitemid 40116669)
18. Sirianni, R., Mayhew, B. A., Carr, B. R., Parker, C. R. Jr & Rainey, W. E. Corticotropin-releasing hormone (CRH) and urocortin act through type 1 CRH receptors to stimulate dehydroepiandrosterone sulfate production in human fetal adrenal cells. J. Clin. Endocrinol. Metab. 90, 5393-5400 (2005). (Pubitemid 41262307)
19. Smith, R., Mesiano, S., Chan, E. C., Brown, S. & Jaffe, R. B. Corticotropin-releasing hormone directly and preferentially stimulates dehydroepiandrosterone sulfate secretion by human fetal adrenal cortical cells. J. Clin. Endocrinol. Metab. 83, 2916-2920 (1998). (Pubitemid 28493798)
20. Petraglia, F., Sawchenko, P. E., Rivier, J. & Vale, W. Evidence for local stimulation of ACTH secretion by corticotropin-releasing factor in human placenta. Nature 328, 717-719 (1987). (Pubitemid 17125774)
21. Goland, R. S., Wardlaw, S. L., Stark, R. I., Brown, L. S. Jr & Frantz, A. G. High levels of corticotropin-releasing hormone immunoactivity in maternal and fetal plasma during pregnancy. J. Clin. Endocrinol. Metab. 63, 1199-1203 (1986). (Pubitemid 17173061)
22. Florio, P., Woods, R. J., Genazzani, A. R., Lowry, P. J. & Petraglia, F. Changes in amniotic fluid immunoreactive corticotropin-releasing factor (CRF) and CRF-binding protein levels in pregnant women at term and during labor. J. Clin. Endocrinol. Metab. 82, 835-838 (1997). (Pubitemid 27106597)
23. Chrousos, G. P., Torpy, D. J.& Gold, P. W. Interactions between the hypothalamic- pituitary-adrenal axis and the female reproductive system: clinical implications. Ann. Intern. Med. 129, 229-240 (1998). (Pubitemid 28377514)
24. Robinson, B. G., Emanuel, R. L., Frim, D. M. & Majzoub, J. A. Glucocorticoid stimulates expression of corticotropin-releasing hormone gene in human placenta. Proc. Natl Acad. Sci. USA 85, 5244-5248 (1988).
25. Jones, S. A., Brooks, A. N. & Challis, J. R. Steroids modulate corticotropin-releasing hormone production in human fetal membranes and placenta. J. Clin. Endocrinol. Metab. 68, 825-830 (1989). (Pubitemid 19089016)
26. Bocian-Sobkowska, J., Malendowicz, L. K. & Wozniak, W. Comparative stereological study on zonation and cellular composition of adrenal glands of normal and anencephalic human fetuses. I. Zonation of the gland. Histol. Histopathol. 12, 311-317 (1997). (Pubitemid 27240302)
27. Krude, H. et al. Severe early-onset obesity, adrenal insufficiency and red hair pigmentation caused by POMC mutations in humans. Nat. Genet. 19, 155-157 (1998). (Pubitemid 28248796)
28. Jackson, R. S. et al. Small-intestinal dysfunction accompanies the complex endocrinopathy of human proprotein convertase 1 deficiency. J. Clin. Invest. 112, 1550-1560 (2003). (Pubitemid 38056281)
29. Clark, A. J., McLoughlin, L. & Grossman, A. Familial glucocorticoid deficiency associated with point mutation in the adrenocorticotropin receptor. Lancet 341, 461-462 (1993). (Pubitemid 23054520)
30. Metherell, L. A. et al. Mutations in MRAP, encoding a new interacting partner of the ACTH receptor, cause familial glucocorticoid deficiency type 2. Nat. Genet. 37, 166-170 (2005).
31. Metherell, L. A., Chan, L. F. & Clark, A. J. The genetics of ACTH resistance syndromes. Best Pract. Res. Clin. Endocrinol. Metab. 20, 547-560 (2006). (Pubitemid 44849159)
32. Metherell, L. A. et al. Nonclassic lipoid congenital adrenal hyperplasia masquerading as familial glucocorticoid deficiency. J. Clin. Endocrinol. Metab. 94, 3865-3871 (2009).
33. Hughes, C. R. et al. MCM4 mutation causes adrenal failure, short stature, and natural killer cell deficiency in humans. J. Clin. Invest. 122, 814-820 (2012).
34. Meimaridou, E. et al. Mutations in NNT encoding nicotinamide nucleotide transhydrogenase cause familial glucocorticoid deficiency. Nat. Genet. 44, 740-742 (2012).
35. Parker, K. L. et al. Steroidogenic factor 1: an essential mediator of endocrine development. Recent Prog. Horm. Res. 57, 19-36 (2002).
36. Hanley, N. A., Rainey, W. E., Wilson, D. I., Ball, S. G. & Parker, K. L. Expression profiles of SF-1, DAX1, and CYP17 in the human fetal adrenal gland: potential interactions in gene regulation. Mol. Endocrinol. 15, 57-68 (2001). (Pubitemid 32156041)
37. Peter, M., Viemann, M., Partsch, C. J. & Sippell, W. G. Congenital adrenal hypoplasia: clinical spectrum, experience with hormonal diagnosis, and report on new point mutations of the DAX-1 gene. J. Clin. Endocrinol. Metab. 83, 2666-2674 (1998). (Pubitemid 28493758)
38. Shen, W. H., Moore, C. C., Ikeda, Y., Parker, K. L. & Ingraham, H. A. Nuclear receptor steroidogenic factor 1 regulates the Müllerian inhibiting substance gene: a link to the sex determination cascade. Cell 77, 651-661 (1994).
39. Achermann, J. C., Ito, M., Ito, M., Hindmarsh, P. C. & Jameson, J. L. A mutation in the gene encoding steroidogenic factor-1 causes XY sex reversal and adrenal failure in humans. Nat. Genet. 22, 125-126 (1999). (Pubitemid 29264799)
40. El-Khairi, R., Martinez-Aguayo, A., Ferraz-de-Souza, B., Lin, L. & Achermann, J. C. Role of DAX-1 (NR0B1) and steroidogenic factor-1 (NR5A1) in human adrenal function. Endocr. Dev. 20, 38-46 (2011).
41. Schimmer, B. P. & White, P. C. Minireview: steroidogenic factor 1: its roles in differentiation, development, and disease. Mol. Endocrinol. 24, 1322-1337 (2010).
42. Speiser, P. W. et al. Congenital adrenal hyperplasia due to steroid 21-hydroxylase deficiency: an Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab. 95, 4133-4160 (2010).
43. Lekarev, O., Mallet, D., Yuen, T., Morel, Y. & New, M. I. Congenital lipoid adrenal hyperplasia (a rare form of adrenal insufficiency and ambiguous genitalia) caused by a novel mutation of the steroidogenic acute regulatory protein gene. Eur. J. Pediatr. 171, 787-793 (2012).
44. Hauffa, B. & Hiort, O. P450 side-chain cleavage deficiency-a rare cause of congenital adrenal hyperplasia. Endocr. Dev. 20, 54-62 (2011).
45. Krone, N. & Arlt, W. Genetics of congenital adrenal hyperplasia. Best Pract. Res. Clin. Endocrinol. Metab. 23, 181-192 (2009).
46. Nimkarn, S. & New, M. I. Prenatal diagnosis and treatment of congenital adrenal hyperplasia owing to 21-hydroxylase deficiency. Nat. Clin. Pract. Endocrinol. Metab. 3, 405-413 (2007). (Pubitemid 46650667)
47. New, M. I. et al. Prenatal diagnosis for congenital adrenal hyperplasia in 532 pregnancies. J. Clin. Endocrinol. Metab. 86, 5651-5657 (2001). (Pubitemid 33152603)
48. Lajic, S., Nordenström, A. & Hirvikoski, T. Long-term outcome of prenatal dexamethasone treatment of 21-hydroxylase deficiency. Endocr. Dev. 20, 96-105 (2011).
49. Mercè Fernández-Balsells, M. et al. Prenatal dexamethasone use for the prevention of virilization in pregnancies at risk for classical congenital adrenal hyperplasia because of 21-hydroxylase (CYP21A2) deficiency: a systematic review and meta-analyses. Clin. Endocrinol. (Oxf.) 73, 436-444 (2010).
50. Reisch, N. et al. High prevalence of reduced fecundity in men with congenital adrenal hyperplasia. J. Clin. Endocrinol. Metab. 94, 1665-1670 (2009).
51. Hagenfeldt, K. et al. Fertility and pregnancy in outcome in women with congenital adrenal hyperplasia due to 21-hydroxylase deficiency. Hum. Reprod. 23, 1607-1613 (2008). (Pubitemid 351809706)
52. Casteràs, A., De Silva, P., Rumsby, G. & Conway, G. S. Reassessing fecundity in women with classical congenital adrenal hyperplasia (CAH): normal pregnancy rate but reduced fertility rate. Clin. Endocrinol. (Oxf.) 70, 833-837 (2009).
53. Lo, J. C. et al. Normal female infants born of mothers with classic congenital adrenal hyperplasia due to 21-hydroxylase deficiency. J. Clin. Endocrinol. Metab. 84, 930-936 (1999). (Pubitemid 29138220)
54. Bidet, M. et al. Fertility in women with nonclassical congenital adrenal hyperplasia due to 21-hydroxylase deficiency. J. Clin. Endocrinol. Metab. 95, 1182-1190 (2010).
55. Flück, C. E. et al. Mutant P450 oxidoreductase causes disordered steroidogenesis with and without Antley-Bixler syndrome. Nat. Genet. 36, 228-230 (2004). (Pubitemid 38282745)
56. Craig, W. Y. et al. Prevalence of steroid sulfatase deficiency in California according to race and ethnicity. Prenat. Diagn. 30, 893-898 (2010).
57. Taylor, N. F. Review: placental sulphatase deficiency. J. Inherit. Metab. Dis. 5, 164-176 (1982).
58. Hauri-Hohl, A. et al. Aromatase deficiency due to a functional variant in the placenta promoter and a novel missense mutation in the CYP19A1 gene. Clin. Endocrinol. (Oxf.) 75, 39-43 (2011).
59. Morishima, A., Grumbach, M. M., Simpson, E. R., Fisher, C. & Qin, K. Aromatase deficiency in male and female siblings caused by a novel mutation and the physiological role of estrogens. J. Clin. Endocrinol. Metab. 80, 3689-3698 (1995).
60. Dörr, H. G. et al. Longitudinal study of progestins, mineralocorticoids, and glucocorticoids throughout human pregnancy. J. Clin. Endocrinol. Metab. 68, 863-868 (1989). (Pubitemid 19127401)
61. Landau, R. L. & Lugibihl, K. The catabolic and natriuretic effects of progesterone in man. Recent Prog. Horm. Res. 17, 249-292 (1961).
62. Parker, C. R., Jr., Cutrer, S., Casey, M. L. & MacDonald, P. C. Concentrations of deoxycorticosterone, deoxycorticosterone sulfate, and progesterone in maternal venous serum and umbilical arterial and venous sera. Am. J. Obstet. Gynecol. 145, 427-432 (1983). (Pubitemid 13138128)
63. Casey, M. L. & MacDonald, P. C. Extraadrenal formation of a mineralocorticosteroid: deoxycorticosterone and deoxycorticosterone sulfate biosynthesis and metabolism. Endocr. Rev. 3, 396-403 (1982).
64. Carr, B. R., Parker, C. R. Jr, Madden, J. D., MacDonald, P. C. & Porter, J. C. Maternal plasma adrenocorticotropin and cortisol relationships throughout human pregnancy. Am. J. Obstet. Gynecol. 139, 416-422 (1981). (Pubitemid 11191259)
65. Burke, C. W. Biologically active cortisol in plasma of oestrogen-treated and normal subjects. Br. Med. J. 2, 798-800 (1969).
66. Sasaki, A. et al. Immunoreactive corticotropin-releasing hormone present in human plasma may be derived from both hypothalamic and extrahypothalamic sources. J. Clin. Endocrinol. Metab. 65, 176-182 (1987). (Pubitemid 17092107)
67. 3-estrogens in normal pregnant women. J. Clin. Endocrinol. Metab. 23, 1298-1301 (1963).
68. Bélisle, S., Schiff, I. & Tulchinsky, D. The use of constant infusion of unlabeled dehydroepiandrosterone for the assessment of its metabolic clearance rate, its half-life, and its conversion into estrogens. J. Clin. Endocrinol. Metab. 50, 117-121 (1980). (Pubitemid 10203586)
69. Crane, M. G., Andes, J. P., Harris, J. J. & Slate, W. G. Primary aldosteronism in pregnancy. Obstet. Gynecol. 23, 200-208 (1964).
70. Ananth, C. V., Peltier, M. R., Kinzler, W. L., Smulian, J. C. & Vintzileos, A. M. Chronic hypertension and risk of placental abruption: is the association modified by ischemic placental disease? Am. J. Obstet. Gynecol. 197, 273.e1-273.e7 (2007).
71. Sibai, B. M. Chronic hypertension in pregnancy. Obstet. Gynecol. 100, 369-377 (2002). (Pubitemid 34874806)
72. Chappell, L. C. et al. Adverse perinatal outcomes and risk factors for preeclampsia in women with chronic hypertension: a prospective study. Hypertension 51, 1002-1009 (2008). (Pubitemid 351398985)
73. Ronconi, V., Turchi, F., Zennaro, M. C., Boscaro, M. & Giacchetti, G. Progesterone increase counteracts aldosterone action in a pregnant woman with primary aldosteronism. Clin. Endocrinol. (Oxf.) 74, 278-279 (2011).
74. Biglieri, E. G. & Slaton, P. E. Jr. Pregnancy and primary aldosteronism. J. Clin. Endocrinol. Metab. 27, 1628-1632 (1967).
75. Aoi, W. et al. Primary aldosteronism aggravated during peripartum period. Jpn Heart J. 19, 946-953 (1978). (Pubitemid 9193121)
76. Gordon, R. D. & Tunny, T. J. Aldosterone-producing-adenoma (A-P-A): effect of pregnancy. Clin. Exp. Hypertens. A 4, 1685-1693 (1982). (Pubitemid 13246192)
77. Murakami, T., Watanabe Ogura, E., Tanaka, Y. & Yamamoto, M. High blood pressure lowered by pregnancy. Lancet 356, 1980 (2000).
78. Quinkler, M., Meyer, B., Oelkers, W. & Diederich, S. Renal inactivation, mineralocorticoid generation, and 11beta-hydroxysteroid dehydrogenase inhibition ameliorate the antimineralocorticoid effect of progesterone in vivo. J. Clin. Endocrinol. Metab. 88, 3767-3772 (2003). (Pubitemid 37034526)
79. Albiger, N. M. et al. A case of primary aldosteronism in pregnancy: do LH and GNRH receptors have a potential role in regulating aldosterone secretion? Eur. J. Endocrinol. 164, 405-412 (2011).
80. Wyckoff, J. A. et al. Glucocorticoid-remediable aldosteronism and pregnancy. Hypertension 35, 668-672 (2000). (Pubitemid 30108166)
81. Funder, J. et al. Case detection, diagnosis, and treatment of patients with primary aldosteronism: an Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab. 93, 3266-3281 (2008).
82. Messina, M., Biffignandi, P., Ghigo, E., Jeantet, M. G. & Molinatti, G. M. Possible contraindication of spironolactone during pregnancy. J. Endocrinol. Invest. 2, 222 (1979). (Pubitemid 9243278)
83. Groves, T. D. & Corenblum, B. Spironolactone therapy during human pregnancy. Am. J. Obstet. Gynecol. 172, 1655-1656 (1995).
84. Regitz-Zagrosek, V. et al. ESC Guidelines on the management of cardiovascular diseases during pregnancy: the Task Force on the Management of Cardiovascular Diseases during Pregnancy of the European Society of Cardiology (ESC). Eur. Heart J. 32, 3147-3197 (2011).
85. Al-Ali, N. A., El-Sandabesee, D., Steel, S. A. & Roland, J. M. Conn's syndrome in pregnancy successfully treated with amiloride. J. Obstet. Gynaecol 27, 730-731 (2007). (Pubitemid 350135679)
86. Cabassi, A., Rocco, R., Berretta, R., Regolisti, G. & Bacchi-Modena, A. Eplerenone use in primary aldosteronism during pregnancy. Hypertension 59, e18-e19 (2012).
87. Nieman, L. K. et al. The diagnosis of Cushing's syndrome: an Endocrine Society clinical practice guideline. J. Clin. Endocrinol. Metab. 93, 1526-1540 (2008). (Pubitemid 351656485)
88. Lado-Abeal, J. et al. Menstrual abnormalities in women with Cushing's disease are correlated with hypercortisolemia rather than raised circulating androgen levels. J. Clin. Endocrinol. Metab. 83, 3083-3088 (1998). (Pubitemid 28500938)
89. Buescher, M. A., McClamrock, H. D. & Adashi, E. Y. Cushing syndrome in pregnancy. Obstet. Gynecol. 79, 130-137 (1992).
90. Wallace, C., Toth, E. L., Lewanczuk, R. Z. & Siminoski, K. Pregnancy-induced Cushing's syndrome in multiple pregnancies. J. Clin. Endocrinol. Metab. 81, 15-21 (1996).
91. Close, C. F., Mann, M. C., Watts, J. F. & Taylor, K. G. ACTH-independent Cushing's syndrome in pregnancy with spontaneous resolution after delivery: control of the hypercortisolism with metyrapone. Clin. Endocrinol. (Oxf.) 39, 375-379 (1993). (Pubitemid 23274439)
92. Chui, M. H. et al. Case report: Adrenal LH/hCG receptor overexpression and gene amplification causing pregnancy-induced Cushing's syndrome. Endocr. Pathol. 20, 256-261 (2009).
93. Lacroix, A., Ndiaye, N., Tremblay, J. & Hamet, P. Ectopic and abnormal hormone receptors in adrenal Cushing's syndrome. Endocr. Rev. 22, 75-110 (2001). (Pubitemid 32187804)
94. Rask, E. et al. Adrenocorticotropin-independent Cushing's syndrome in pregnancy related to overexpression of adrenal luteinizing hormone/human chorionic gonadotropin receptors. J. Endocrinol. Invest. 32, 313-316 (2009).
95. Wy, L. A. et al. Pregnancy-associated Cushing's syndrome secondary to a luteinizing hormone/human chorionic gonadotropin receptor-positive adrenal carcinoma. Gynecol. Endocrinol. 16, 413-417 (2002). (Pubitemid 35398657)
96. Lindsay, J. R., Jonklaas, J., Oldfield, E. H. & Nieman, L. K. Cushing's syndrome during pregnancy: personal experience and review of the literature. J. Clin. Endocrinol. Metab. 90, 3077-3083 (2005). (Pubitemid 40686367)
97. Pricolo, V. E. et al. Management of Cushing's syndrome secondary to adrenal adenoma during pregnancy. Surgery 108, 1072-1077 (1990).
98. Erichsen, M. M., Husebye, E. S., Michelsen, T. M., Dahl, A. A. & Løvås, K. Sexuality and fertility in women with Addison's disease. J. Clin. Endocrinol. Metab. 95, 4354-4360 (2010).
99. Björnsdottir, S. et al. Addison's disease in women is a risk factor for an adverse pregnancy outcome. J. Clin. Endocrinol. Metab. 95, 5249-5257 (2010).
100. Winqvist, O., Gustafsson, J., Rorsman, F., Karlsson, F. A. & Kämpe, O. Two different cytochrome P450 enzymes are the adrenal antigens in autoimmune polyendocrine syndrome type I and Addison's disease. J. Clin. Invest. 92, 2377-2385 (1993). (Pubitemid 23333545)
101. Albert, E., Dalaker, K., Jorde, R. & Berge, L. N. Addison's disease and pregnancy. Acta Obstet. Gynecol. Scand. 68, 185-187 (1989). (Pubitemid 20011681)
102. Ambrosi, B., Barbetta, L. & Morricone, L. Diagnosis and management of Addison's disease during pregnancy. J. Endocrinol. Invest. 26, 698-702 (2003). (Pubitemid 37270707)
103. Fux Otta, C., Szafryk de Mereshian, P., Iraci, G. S. & Ojeda de Pruneda, M. R. Pregnancies associated with primary adrenal insufficiency. Fertil. Steril. 90, 1199.e17-1199. e20 (2008).
104. Grinspoon, S. K. & Biller, B. M. Clinical review 62: Laboratory assessment of adrenal insufficiency. J. Clin. Endocrinol. Metab. 79, 923-931 (1994).
105. Suri, D., Moran, J., Hibbard, J. U., Kasza, K. & Weiss, R. E. Assessment of adrenal reserve in pregnancy: defining the normal response to the adrenocorticotropin stimulation test. J. Clin. Endocrinol. Metab. 91, 3866-3872 (2006). (Pubitemid 44536856)
106. Drucker, D., Shumak, S. & Angel, A. Schmidt's syndrome presenting with intrauterine growth retardation and postpartum addisonian crisis. Am. J. Obstet. Gynecol. 149, 229-230 (1984). (Pubitemid 14103925)
107. Lenders, J. W., Eisenhofer, G., Mannelli, M. & Pacak, K. Phaeochromocytoma. Lancet 366, 665-675 (2005). (Pubitemid 41176020)
108. Lenders, J. W. Pheochromocytoma and pregnancy: a deceptive connection. Eur. J. Endocrinol. 166, 143-150 (2012).
109. Schenker, J. G. & Chowers, I. Pheochromocytoma and pregnancy. Review of 89 cases. Obstet. Gynecol. Surv. 26, 739-747 (1971).
110. Ahlawat, S. K., Jain, S., Kumari, S., Varma, S. & Sharma, B. K. Pheochromocytoma associated with pregnancy: case report and review of the literature. Obstet. Gynecol. Surv. 54, 728-737 (1999). (Pubitemid 29508686)
111. Desai, A. S., Chutkow, W. A., Edelman, E., Economy, K. E. & Dec, G. W. Jr. A crisis in late pregnancy. N. Engl. J. Med. 361, 2271-2277 (2009).
112. Hudsmith, J. G., Thomas, C. E. & Browne, D. A. Undiagnosed phaeochromocytoma mimicking severe preeclampsia in a pregnant woman at term. Int. J. Obstet. Anesth. 15, 240-245 (2006).
113. Newell, K. A. et al. Pheochromocytoma multisystem crisis. A surgical emergency. Arch. Surg. 123, 956-959 (1988).
114. Lentschener, C., Gaujoux, S., Tesniere, A. & Dousset, B. Point of controversy: perioperative care of patients undergoing pheochromocytoma removal-time for a reappraisal? Eur. J. Endocrinol. 165, 365-373 (2011).
115. Mannelli, M. & Bemporad, D. Diagnosis and management of pheochromocytoma during pregnancy. J. Endocrinol. Invest. 25, 567-571 (2002). (Pubitemid 34661849)
116. Natrajan, P. G., McGarrigle, H. H., Lawrence, D. M. & Lachelin, G. C. Plasma noradrenaline and adrenaline levels in normal pregnancy and in pregnancy-induced hypertension. Br. J. Obstet. Gynaecol 89, 1041-1045 (1982). (Pubitemid 13203718)
117. Zuspan, F. P. Urinary excretion of epinephrine and norepinephrine during pregnancy. J. Clin. Endocrinol. Metab. 30, 357-360 (1970).