A case of Cushing's syndrome in pregnancy.

Cushing's syndrome (also known as hypercortisolemia) is rare in pregnant women due to the menstrual disturbances and infertility in women with hypercortisolism. A diagnosis of pathological hypercortisolism in pregnant women is often difficult as some symptoms of the disease may be associated with a complicated pregnancy. Hypercortisolemia leads to serious complications for mother and foetus, and is associated with premature labour and high foetal mortality. Hormonal and radiological diagnostics in pregnancy are limited. The results of hormonal measurements and dynamic tests are difficult to interpret due to the physiological changes in the hypothalamo-pituitaryadrenal axis connected with pregnancy. The optimal time and method of treatment should be chosen cautiously case by case because of the possibility of maternal and foetal complications. In this paper, we present a case of Cushing's syndrome secondary to adrenal adenoma in which the diagnosis was made in the 22(nd) week of pregnancy. Due to the advanced gestational status and mild symptoms of hypercortisolism, only symptomatic treatment was introduced. The patient was under continuous obstetric and endocrinological care. At 35 weeks of gestation, the pregnancy was terminated by emergency caesarean section because of premature detachment of the placenta. A male infant weighing 2,450 g was delivered; neither adrenal insufficiency in the child nor hypercortisolemia complications in the mother were observed.

Inhibin B and FSH as markers of Sertoli cell function in impaired spermatogenesis.

INTRODUCTION: The relationships between inhibin B, FSH and sperm count have never been fully elucidated. Our aim was to search for associations between serum concentrations of inhibin B/FSH and the impairment of spermatogenesis. MATERIAL AND METHODS: In an observational study, we compared sperm count, serum levels of inhibin B and FSH in men with oligozoospermia (n = 46) and in normozoospermic, fertile controls (n = 38). RESULTS: Concentration of FSH was 10.27 ± 11.24 IU/L in the oligozoospermic and 3.84 ± 2.76 IU/L in the normospermic group (p 〈 0.01). Although the concentration of inhibin B was higher in the oligozoospermic group (424 ± 443 v. 297 ± 219 pg/mL), the difference was statistically insignificant. CONCLUSIONS: Our results suggest that there is a tendency toward increased serum inhibin B levels in subjects with altered sperm count and increased serum FSH.

Breast cancer and long-term hormonal treatment of male hypogonadism.

Breast cancer in men is rare and its etiology is multifactorial. Androgens may promote the development of breast carcinoma in men though data on the subject is scarce. We observed 45 men with hypergonadotropic hypogonadism (aged 18-57) who received 250 mg of testosterone esters (Omnadren 250, Jelfa, Poland) every 3-4 weeks for 5-26 years. Seventeen of them were treated for more than 10 years. During the observation period breast cancer was diagnosed in 2 subjects (11% of the followed men). In one case it occurred after 11 years and in the other after 15 years of the therapy. We point to a possible association between long-term androgen replacement and a risk of breast cancer in men.