Endocrine Abstracts

The fertility is commonly impaired in acromegalic patients; therefore, pregnancy in acromegaly is relatively a rare event. Little is known about management of pregnant acromegalic patients and the out come of their pregnancies. This is a report of a rather unusual case of a 37-year-old acromegalic lady diagnosed in 2001. Transphenoidal surgery 2002 continued having GH IGF1A so who had two successful pregnancies in spite her active disease. She was diagnosed in 2002 after a clinical, biochemical and MRI confirmation. Her acromegaly was treated with transphenpoidal surgery 2002 followed by sandostatin (long acting octereotide) as growth hormone remained high after surgery.

This was further complicated with incidental findings of; renal cell carcinoma and thyroid cyst and parathyroid adenoma 2003 for which patient had partial nephrectomy and parathyroid and follicular thyroid cyst removal respectively. In 2006, patient became pregnant and sandostatin was stopped despite the constantly high GH.

Results: Interestingly, while being actively acromegalic and few months before establishing the diagnosis; patient had a normal pregnancy in 2001 and full term delivery to a normal baby boy. While being partially treated patient became pregnant again in 2005 and sandostatin had to be stopped, however, uneventful term delivery occurred. During pregnancy variable levels of GH of 23.9–33.8, IGF-1 55.0–116.0 and Somatomedin C 62.7–187.6.

Conclusions: Management of acromegaly in pregnancy can be difficult as the available treatment could harm foetus, therefore, it is commonly stopped during pregnancy. However, untreated active acromegaly in pregnancy could also have serious metabolic and vascular complications which might cause serious impact of the foetus or miscarriage.