Lipodystrophy during pegvisomant therapy: a case report and review of the literature

Büyüktaş, Deram; Çelik, Özlem; Kantarcı, Fatih; Kadıoğlu, Pınar

doi:10.1590/s1807-59322010000900018

Cited by 5 publications

(4 citation statements)

References 7 publications

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“…Lipodystrophy is a pegvisomant‐related side effect, anecdotally described, more frequent in women, as observed in the present study, where 13/15 patients with lipodystrophy were females. Moreover, lipohypertrophy is more common than lipoatrophy, as occurs in the present study.…”

Section: Discussionsupporting

confidence: 67%

“…These localized adipose tissue changes result in depressed skin areas (lipoatrophy) or areas of fat overgrowth (lipohypertrophy). The clinical observation of pegvisomant‐related lipodystrophy has been documented in a number of cases; however, the pathogenesis is still unclear . There is a pathophysiologic association between GH and adipose tissue depots, especially in the abdominal area .…”

Section: Introductionmentioning

confidence: 99%

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Escape and lipodystrophy in acromegaly during pegvisomant therapy, a retrospective multicentre Spanish study

Sesmilo

Resmini

Bernabéu

et al. 2014

Clinical Endocrinology

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Section: Discussionsupporting

confidence: 67%

Section: Introductionmentioning

confidence: 99%

Escape and lipodystrophy in acromegaly during pegvisomant therapy, a retrospective multicentre Spanish study

Sesmilo

Resmini

Bernabéu

et al. 2014

Clinical Endocrinology

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“…Liver toxicity is usually reversible after decrease or discontinuation of pegvisomant [7]. Pegvisomant is also associated with lipohypertrophy at the injection site or at distant sites [10,11].…”

Section: Discussionmentioning

confidence: 99%

Abducens nerve palsy during pegvisomant therapy in an acromegalic patient

Hatipoğlu¹,

Kepicoglu²,

Başar³

et al. 2013

OJIM

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Pegvisomant is a recent treatment modality of acromegaly, which is most effective in regulating IGF-1 levels. Tumor growth has been reported in 5% of the acromegaly cases treated with pegvisomant. Herein we report a case of acromegaly resistant to surgical treatment, radiotherapy and medical therapy with a somatostatin analogue and cabergolin. Due to presence of pituitary tumor with cavernous sinus invasion and unremitting disease activity pegvisomant therapy was initiated. She developed left abducens nerve palsy after pegvisomant treatment. The objective of this report is to emphasize the value of close follow-up of the acromely cases under pegvisomant therapy, especially if they have cavernous sinus infiltrating tumor. A 44-year-old woman with acromegaly presented with visual defect and diplopia on left lateral gaze. Her complaint developed 3 years after initiation of pegvisomant therapy. Her neurologic examination was consistent with mild abducens nerve palsy on left side. Other causes for abducens nerve palsy were excluded. Pegvisomant was discontinued upon patient request. Although sella MRI did not reveal a tumor growth, even minimal growth within cavernous sinus can cause cranial nerve involvement. Therefore close and careful follow-up of cavernous sinus infiltrating tumors after pegvisomant therapy is crucial to early recognition of complications.

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“…In the German Acrostudy 12 out of 371 patients reported some degree of lipohypertrophy [ 193 ]. An impressive form of lipohypertrophy has been illustrated by Buyuktas et al in one patient [ 196 ]. Pathophysiologically the GH antagonism of Pegvisomant may reduce the lipolytic effect of GH and thus increase local fat deposition.…”

Section: Options For Medical Therapymentioning

confidence: 99%

Medical Therapy of Acromegaly

Plöckinger

2012

International Journal of Endocrinology

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This paper outlines the present status of medical therapy of acromegaly. Indications for permanent postoperative treatment, postirradiation treamtent to bridge the interval until remission as well as primary medical therapy are elaborated. Therapeutic efficacy of the different available drugs—somatostatin receptor ligands (SRLs), dopamine agonists, and the GH antagonist Pegvisomant—is discussed, as are the indications for and efficacy of their respective combinations. Information on their mechanism of action, and some pharmakokinetic data are included. Special emphasis is given to the difficulties to define remission criteria of acromegaly due to technical assay problems. An algorithm for medical therapy in acromegaly is provided.

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Lipodystrophy during pegvisomant therapy: a case report and review of the literature

Cited by 5 publications

References 7 publications

Escape and lipodystrophy in acromegaly during pegvisomant therapy, a retrospective multicentre Spanish study

Escape and lipodystrophy in acromegaly during pegvisomant therapy, a retrospective multicentre Spanish study

Abducens nerve palsy during pegvisomant therapy in an acromegalic patient

Medical Therapy of Acromegaly

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