Endocrine Abstracts

In 24 years old woman in March 2007 was diagnosed acromegaly (somatoprolactinoma) an active phase, hyperprolactinemia. Manifestations: rugged features, amenorrhea, galactorrhea, fasting GH – 144 ng/ml (N<10 ng/ml), IGF-1 – 586 ng/ml (N 48–450 ng/ml), PRL – 6726 mU/l (N 40–530 mU/l). According to pituitary MRT a tumor volume was 14.4 cm³, with supra- and infrasella growth. She was operated in May 2007: transnal transsphenoidal subtotal removal of the pituitary adenoma. After adenomectomia: GH nadir in OGTT was 28.1 mU/l (N<2.7 mU/l), IGF-1 – 952 ng/ml, PRL – 111 mU/l. Pituitary MRT: endo- and parasella adenoma components 5.7 cm³ volume. Galactorrhea persists. Long acting somatostatin (Oktreotid-depot) was prescribed in July 2007 in start dose 20 mg/month, and it was increased in Sept 2007 to 30 mg to suppress GH secretion (GH nadir 26.4 mU/l, IGF-1 601 ng/ml). Oktreotid-depot treatment induced a reduction in volume postoperative adenoma components from 5.7 cm³ to 4.5 cm³. After 4th Oktreotid-depot injection (30 mg/m) 24 weeks pregnancy has been diagnosed. Oktreotid-depot treatment has been continued up to physiological childbirth at 40^th weeks. The child was healthy: weight – 3 250 g, growth – 52 cm, 9 points on Apgar scale. Acromegaly signs did not worsen during pregnancy and after childbirth.