Endocrine Abstracts

Introduction: Acromegaly is a rare disease caused by an increased secretion of GH, usually derived from a benign pituitary tumor. Women with acromegaly are usually infertile, because of tumoral hypersecretion, compression or surgical sequelae. We can prevent infertility with an adequate treatment. There are some reports describing pregnacies among acromegalic women. It is believed that there is an increased risk of develloping diabetes mellitus and hypertension, especially when there is an active or uncontrolled acromegaly, and a symptomatic tumor size increase during pregnancy.

Case Report: Thirty five year-old woman, with acromegaly diagnosed when she was 24: IGF1=1305 ng/ml (n: 75–780); GH=78 ng/ml (n: 0–18); prolactin=38.8 ng/ml (n: 0–25). The sellar magnetic resonance imaging (MRI) showed an expansive rounded sellar lesion (20×20×20 mm), with supra-sellar expansion, optic chiasm stretch and left stalk deviation. She underwent transphenoidal adenomectomy on 20/09/2001 (9 months after diagnosis). The histology confirmed a GH producing adenoma. She wasn’t cured by surgery (GH=8.8 ng/ml (n: 0–8.6); IGF1=1355 ng/ml (n: 150–780)), so she started on medical treatment with octreotide-LAR (20 mg), once a month, on 25/01/2002, becoming assymptomatic. Seven and nine years after surgery, she had two term pregnancies, both delivered by elective caesarean, normossomic newborns, without malformations or neonatal complications. Octreotide was stopped once the pregnancy diagnosis was made. The patient had neither gestational diabetes nor hypertension. There was no sellar changes on MRI and no changes in visual fields. The levels of GH ranged between 1.47 and 8.68 ng/ml and the levels of IGF1 between 188 and 804 ng/ml throughout pregnancies.

Conclusion: As described in the literature, in this patient, acromegaly treatment kept the patient fertile, allowing two pregancies without complications, with normal neonates. Even with the use of octreotide-LAR until the knowledge of the pregnancy diagnosis, there weren’t malformations in both neonates or other complications.

Declaration of interest: The authors declare that there is no conflict of interest that could be perceived as prejudicing the impartiality of the research project.

Funding: This research did not receive any specific grant from any funding agency in the public, commercial or not-for-profit sector.