Document Detail


Normal pregnancy in a woman with nesidioblastosis treated with somatostatin analog octreotide.
MedLine Citation:
PMID:  15279081     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: We report the case of a 36-yr-old woman with nesidioblastosis treated throughout pregnancy with high doses of octreotide. We studied the course of blood glucose, foetal growth and development. METHODS: Blood samples were obtained every month throughout pregnancy and taken at birth from the umbilical cord. Sonography was performed repeatedly to monitor foetal growth. RESULTS: The daily dose of octreotide was adapted to blood glucose levels: a dose of 1000 microg was infused during the first part of pregnancy, then it was decreased step by step during the last trimester of gestation. An elective cesarean section was performed at 32 weeks of gestation. High octreotide concentrations were obtained during the first part of gestation (range 2888-5021 pg/ml). During the third trimester of pregnancy blood glucose increased despite high insulin levels attesting physiological insulin-resistance. Plasma levels of placental GH and IGF-1 levels were similar to those observed in a normal pregnancy. Despite the presence of octreotide in the umbilical cord, TSH, free T4, PRL and pituitary GH concentrations were normal at birth. The female newborn (weight 3520 g, length 52 cm) had no malformation, and presented with normal postnatal development. CONCLUSION: Our study demonstrates that: 1) octreotide treatment can be effective in controlling endogenous hyperinsulinism during pregnancy; 2) octreotide does not affect physiological changes during pregnancy such as insulin-resistance or placental GH level; 3) exposure of the foetus to octreotide throughout pregnancy does not induce any malformation and does not affect foetal development.
Authors:
C Boulanger; D Vezzosi; A Bennet; F Lorenzini; J Fauvel; P Caron
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of endocrinological investigation     Volume:  27     ISSN:  0391-4097     ISO Abbreviation:  J. Endocrinol. Invest.     Publication Date:  2004 May 
Date Detail:
Created Date:  2004-07-28     Completed Date:  2005-01-13     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7806594     Medline TA:  J Endocrinol Invest     Country:  Italy    
Other Details:
Languages:  eng     Pagination:  465-70     Citation Subset:  IM    
Affiliation:
Department of Endocrinology, Rangueil University Hospital Centre,Toulouse, France.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Glucose / metabolism
Female
Fetal Blood / chemistry
Gastrointestinal Agents / blood,  therapeutic use*
Humans
Infant, Newborn
Insulin
Insulin-Like Growth Factor I
Nesidioblastosis / blood,  drug therapy*,  metabolism
Octreotide / blood,  therapeutic use*
Placenta / metabolism
Pregnancy
Pregnancy Complications / blood,  drug therapy*,  metabolism
Somatostatin / metabolism
Chemical
Reg. No./Substance:
0/Blood Glucose; 0/Gastrointestinal Agents; 11061-68-0/Insulin; 51110-01-1/Somatostatin; 67763-96-6/Insulin-Like Growth Factor I; 83150-76-9/Octreotide

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


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