Document Detail


Clinical and biochemical improvement in acromegaly during pregnancy.
MedLine Citation:
PMID:  18401209     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Numerous case reports of pregnancy in acromegaly exist, however detailed descriptions of changes in placental and pituitary GH and IGF-I throughout gestation are rare. A 19-yr-old female presented to this institution with signs and symptoms of a GH-secreting pituitary adenoma. Following transphenoidal hypophysectomy, she had 3 unplanned pregnancies, despite ongoing active disease. No pregnancy was complicated by glucose intolerance or hypertension and 3 healthy newborns were delivered near or at term. Clinical improvement was observed during each pregnancy, accompanied by IGF-I levels lower than in the non-pregnant state, the majority lying within the normal range. This was despite increasing placental GH levels, and was not consistent with previous reports in the literature. Further surgical and medical therapies for acromegaly failed to normalize nonpregnant GH or IGF-I levels in this woman. Estrogen is known to alter GH signaling via its interaction with Janus kinase/signal transducers and activators of transcription (JAK-STAT) pathways. We hypothesize that increasing concentrations of estrogen or other pregnancy-related hormones resulted in her clinical and biochemical improvement during pregnancy. This may be used for future therapeutic benefit.
Authors:
S L Lau; S McGrath; D Evain-Brion; R Smith
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of endocrinological investigation     Volume:  31     ISSN:  1720-8386     ISO Abbreviation:  J. Endocrinol. Invest.     Publication Date:  2008 Mar 
Date Detail:
Created Date:  2008-04-10     Completed Date:  2008-05-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806594     Medline TA:  J Endocrinol Invest     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  255-61     Citation Subset:  IM    
Affiliation:
Department of Endocrinology, John Hunter Hospital, Newcastle, Australia.
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MeSH Terms
Descriptor/Qualifier:
Acromegaly / drug therapy,  physiopathology*,  surgery
Adult
Female
Human Growth Hormone / analysis,  blood,  secretion
Humans
Hypophysectomy
Insulin-Like Growth Factor I / analysis
Magnetic Resonance Imaging
Pituitary Neoplasms / secretion,  surgery
Placenta / chemistry
Pregnancy
Pregnancy Complications / physiopathology*
Pregnancy Complications, Neoplastic / physiopathology
Pregnancy Outcome
Reoperation
Chemical
Reg. No./Substance:
12629-01-5/Human Growth Hormone; 67763-96-6/Insulin-Like Growth Factor I

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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