Prise en charge de l’acromégalie évolutive au cours de la grossesse

Hachmi, L. Ben Salem; Kammoun, Inès; Bouzid, C.; Smida, H.; Nagi, S.; Turki, Z.; Slama, C. Ben

doi:10.1016/j.ando.2009.10.002

Cited by 10 publications

(2 citation statements)

References 12 publications

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“…The major concern is the potential tumor expansion, attributed to the growth-promoting effect of estrogens, and the consequent risk of visual field defects and neurological complications (18). The medical treatments in use for acromegaly (SSA, GH receptor antagonist) are not approved during pregnancy (22,23); only dopamine agonists can be used if necessary, although their efficacy is limited (disease control is only achieved in 10% of cases) (24). In practice, medical treatment can be safely withdrawn after conception in most cases (22).…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Conception and Term Delivery in a Woman with Ucontrolled Acromegaly and Hypogonadotropic Hypogonadism

et al. 2016

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Background. Patients with acromegaly (caused by growth-hormone-secreting pituitary adenomas) are at increased risk of hypopituitarism, in particular hypogonadotropic hypogonadism, before and after multimodal therapy. In affected women of reproductive age, fertility is impaired and complex fertility treatments are needed to achieve conception. case presentation. We present the case of a young woman with acromegaly caused by a GH-secreting macroadenoma with suprasellar and bilateral cavernous sinus extension; hypogonadotropic hypogonadism and secondary hypothyroidism were present from the initial evaluation. Neurosurgical intervention was repeatedly recommended but the patient refused it initially; also she was non-compliant to the medical treatment of acromegaly. Transsphenoidal tumor debulking with adjuvant gamma-knife radiotherapy was eventually performed. Following treatment persistent active acromegaly and hypogonadotropic hypogonadism were diagnosed. Under chronic estroprogestative replacement therapy, the patient conceived and delivered a full-term healthy newborn without any complications. Possible mechanisms are discussed. conclusions. Secondary hypogonadotropic hypogonadism in pituitary patients, even when considered permanent (after surgery and radiotherapy), can exceptionally allow spontaneous conception and normal course of pregnancy.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Conception and Term Delivery in a Woman with Ucontrolled Acromegaly and Hypogonadotropic Hypogonadism

et al. 2016

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“…[66] Recently lanreotide has been used in pregnant women without any deleterious side effect on fetus. [67] Koshy et al . recently reported a 30-year-old woman who presented with sudden diminution of vision.…”

Section: Pregnancy and Acromegalymentioning

confidence: 99%

Pregnancy and pituitary disorders: Challenges in diagnosis and management

Laway

Mir

2013

Indian J Endocr Metab

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Pregnancy is associated with normal physiological changes in endocrine system that assists fetal survival as well as preparation of labor. The pituitary gland is one of the most affected organs in which major changes in anatomy and physiology take place. Due to overlapping clinical and biochemical features of pregnancy, sometimes the diagnosis of pituitary disorders may be challenging. It is important to know what normal parameters of changes occur in endocrine system in order to diagnose and manage complex endocrine problems in pregnancy. In our present review, we will focus on pituitary disorders that occur exclusively during pregnancy like Sheehan's syndrome and lymphocytic hypophysitis and pre-existing pituitary disorders (like prolactinoma, Cushing's disease and acromegaly), which poses significant challenge to endocrinologists.

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