Endocrine Abstracts

Pregnancy in active acromegaly at reproductive age is very rare occurrence due to hyperprolactinemia, hypogonadism and side effects of treatment of acromegaly. Only a few reports were described in medical literature by now.

We report a 31-year-old woman ongoing active acromegaly despite who received Octeatide LAR 30 mg treatment monthly for the control of GH and IGF1 excess until realized her pregnancy. A GH secreting pituitary macroadenoma (tumor size 2 cm) was diagnosed 3 years ago and twice pituitary transsphenoidal surgery was undergone. Octreatide LAR treatment was started after surgery because of uncontrolled acromegaly. Octreatide LAR treatment was withdrawn as soon as possible after positive pregnancy test. But, she had noticed her pregnancy after 3 weeks from Octeatide LAR injection. During pregnancy, serum IGF1 and GH levels increased gradually. No pregnancy complications were observed and a healthy girl was born at full-term. Lactation was lost spontaneously after postpartum 5 months. Pituitary MRI after the delivery was performed. Postpartum minimally tumor growth in related to pregnancy was observed in pituitary MRI. But, impaired glucose tolerance was developed after delivery.

It is not clear whether Octreatide LAR therapy should discontinue after confirmation of pregnancy in acromegaly. According to date, no adverse effects related to Octreatide LAR therapy were noted in pregnancy. In case of pregnancy, Octreatide LAR therapy in acromegaly may interrupt until established more safely data. Long-term effect of Octreatide LAR treatment is not known at the fetus even if feasibility and safety of treatment with short-acting octreotide in acromegalic women during pregnancy was indicated.