An update on clinical care for pregnant women with acromegaly

Chanson, Philippe; Vialon, M.; Caron, Philippe

doi:10.1080/17446651.2019.1571909

Cited by 25 publications

(21 citation statements)

References 104 publications

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“…The current consensus suggests that they should be stopped once pregnancy is confirmed, and in case a patient wants to remain pregnant, switching to a short-acting SRL until pregnancy confirmation is indicated. 6 In our case, SRL resistance with lack of response of the GH-IGF1 axis even to high doses of lanreotide was noticed, therefore treatment was stopped a few years prior to becoming pregnant. The GH-blocker pegvisomant is an attractive therapeutic option for acromegalic patients, causing considerable reduction of IGF-1 levels and thus leading to less acromegalyrelated complications.…”

Section: Discussionmentioning

confidence: 61%

“…Therefore, current guidelines indicate that there is no reason to advise against breastfeeding in acromegalic patients who presented an uneventful pregnancy. 6,10,11 Our patient breastfed her daughter without any noticeable complications.…”

Section: Discussionmentioning

confidence: 74%

“…In one case, gestational diabetes, pituitary gland growth, and visual disturbance occurred, but the child was safely delivered at 32 weeks, while in the other cases no complications or malformations related to pegvisomant exposure were noted. 6,16 Our presented case had a good response to pegvisomant treatment during the three years prior to deciding on becoming pregnant, with no tumor growth occurring and significant improvements in IGF-1 levels. Treatment was stopped after the patient decided on trying to become pregnant, as recommended by the latest guidelines.…”

Section: Discussionmentioning

confidence: 80%

“…Therefore, a careful observation of these patients is essential in order to achieve the best therapeutic outcomes for both the mother and the fetus. 5,6…”

Section: Introductionmentioning

confidence: 99%

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Successful Pregnancy in a Patient with Long-Standing Acromegaly – a Case Report

Gliga¹,

Pașcanu

Gliga

et al. 2020

Journal of Interdisciplinary Medicine

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Introduction: Acromegaly is a rare endocrine disorder of the growth hormone (GH)-insulin-like growth factor 1 (IGF1) metabolism that can affect women of fertile age. Although uncommon, pregnancies in acromegalic women can occur, with data regarding the management of these cases being very limited, mostly consisting of case reports.Case Presentation: We present the case of an acromegalic woman, first diagnosed at the age of 22, after the surgical resection of a pituitary mass. Throughout the evolution, she received conventional radiotherapy and has been treated with somatostatin receptor ligands (SRLs), dopamine agonists (DAs), and GH-blockers. At the age of 37, the patient decided to become pregnant while she was on Pegvisomant and DA therapy. The treatment was stopped, and the patient became pregnant at the age of 38. Tumor size and IGF-1 values have remained stable throughout the pregnancy, and no complications occurred. A healthy child with normal birth weight was delivered on term through Cesarean section.Conclusions: Managing pregnant women with acromegaly is challenging because of the little available data regarding the safety of medical treatment and a high interindividual variability of GH-IGF-1 evolution during this period. The particularity of our case was a patient with a long history of acromegaly, who had an uneventful pregnancy despite stopping all medical treatment.

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Section: Discussionmentioning

confidence: 61%

Section: Discussionmentioning

confidence: 74%

Section: Discussionmentioning

confidence: 80%

“…Therefore, a careful observation of these patients is essential in order to achieve the best therapeutic outcomes for both the mother and the fetus. 5,6…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Successful Pregnancy in a Patient with Long-Standing Acromegaly – a Case Report

Gliga¹,

Pașcanu

Gliga

et al. 2020

Journal of Interdisciplinary Medicine

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“…Aggressive disease in pregnancy is a rare event. Although drugs for acromegaly are not approved in pregnancy, their use has been occasionally reported for severe symptomatic relapse or even throughout the entire pregnancy, both for bromocriptine/cabergoline [ 90 ], SSAs [ 91 ], and PegV [ 92 ]. SSAs might increase the risk of low birth weight.…”

Section: Clinical Issuesmentioning

confidence: 99%

Italian Association of Clinical Endocrinologists (AME) and Italian AACE Chapter Position Statement for Clinical Practice: Acromegaly - Part 1: Diagnostic and Clinical Issues

Cozzi

Ambrosio

Attanasio

et al. 2020

EMIDDT

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: Acromegaly is a rare disease. Improvements in lifespan in these patients have recently been reported due to transsphenoidal surgery (TSS), advances in medical therapy, and tighter criteria for defining disease remission. This document reports the opinions of a group of Italian experts who have gathered together their prolonged clinical experience in the diagnostic and therapeutic challenges of acromegaly patients. Both GH and IGF-I (only IGF-I in those treated with Pegvisomant - PegV) are needed in the diagnosis and follow-up. Comorbidities (cardio-cerebrovascular disease, sleep apnea, metabolic derangement, neoplasms, and bone/joint disease) should be specifically addressed. Any newly diagnosed patient should be referred to a multidisciplinary team experienced in the treatment of pituitary adenomas.

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Acromegaly: Preconception Management

Jallad

Bronstein

2022

Pituitary Disorders Throughout the Life Cycle

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An update on clinical care for pregnant women with acromegaly

Cited by 25 publications

References 104 publications

Successful Pregnancy in a Patient with Long-Standing Acromegaly – a Case Report

Successful Pregnancy in a Patient with Long-Standing Acromegaly – a Case Report

Italian Association of Clinical Endocrinologists (AME) and Italian AACE Chapter Position Statement for Clinical Practice: Acromegaly - Part 1: Diagnostic and Clinical Issues

Acromegaly: Preconception Management

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