Cleveland Clinic Abu Dhabi Physicians Successfully Treat Rare Hormonal Disorder

Cushing’s disease patient becomes pregnant just four weeks after surgery to remove a tumor from her pituitary gland

A young Emirati woman has given birth to a healthy baby after being successfully treated for a rare hormonal disease by physicians at Cleveland Clinic Abu Dhabi, part of Mubadala’s network of healthcare providers, who removed a tumor from her pituitary gland.

The rare disorder, known as Cushing’s disease, is a serious condition that leads to an excess of the hormone cortisol in the body and affects just 10 to 15 people per million per year. 

Symptoms include excessive weight gain around the abdomen and face, added fat on the back of the neck, known as a “buffalo hump”, an irregular menstruation cycle, muscle weakness, easily bruised skin, thin arms and legs, and excessive hair growth on the face, neck, chest, abdomen and thighs. Other symptoms include decreased fertility, high blood pressure, and mood and behavior disorders.

Cushing’s disease can be difficult to diagnose because it is so rare, but if left untreated it can result in serious complications, such as diabetes mellitus and osteoporosis, or even early death, said Dr. Amir H. Hamrahian, Chief of Endocrinology in the Medical Subspecialties Institute at Cleveland Clinic Abu Dhabi.

“The 27-year-old patient first came to us after experiencing a range of symptoms, such as plethora [reddish complexion of the face], fatigue, dizziness, headaches, increased sweating, tingling, depression and lack of menstruation,” said Dr. Hamrahian. 

“Initial tests found that the patient had elevated cortisol levels, which is a steroid hormone produced by the adrenal gland in response to stress. After further investigation by our multidisciplinary team, which included blood, saliva, and 24-hour urinary tests and working with Cleveland Clinic Abu Dhabi’s Imaging Institute, we discovered a small benign tumor on the patient’s pituitary gland, which confirmed the Cushing’s disease diagnosis,” he added.

The patient underwent transsphenoidal surgery, a cutting-edge procedure that allows surgeons to remove the tumor via the nose and sphenoid sinus with an endoscope. The surgery is considered minimally invasive, resulting in a faster recovery time for the patient.

The pituitary gland plays an important role in our bodies. The size of a pea, it is located behind the eye sockets and is attached to the brain by a thin stem. It is often referred to as the “master gland” as it regulates a number of the body’s glands, including ovaries, testicles, thyroid and adrenals.

Cushing’s disease is named after American neurosurgeon Harvey Cushing, who discovered the disorder in 1932 by finding links between the physical symptoms of the disease and benign tumors on the pituitary gland.

“Surgery usually leads to a remission rate of about 80 percent. I am very happy that this patient is now in remission and just one month after the procedure, the patient became pregnant and has since given birth to a healthy baby,” said Dr. Hamrahian. 

“One of the things about Cushing’s disease is that if you make the correct diagnosis, and the patient is treated by an experienced team, the reward is very high because you have changed a patient’s life.” 

Cleveland Clinic Abu Dhabi’s Medical Subspecialties Institute brings together nine specialties that provide coordinated patient care across a broad spectrum of medical needs. The Institute also has a dedicated pituitary and adrenal clinic to serve the growing number of endocrinology patients in the UAE.