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acromegaly pregnancy

Julio Abucham, M D Bronstein, Monike Lourenço Dias
Although fertility is frequently impaired in women with acromegaly, pregnancy is apparently becoming more common due to improvement in acromegaly treatment as well as in fertility therapy. As a result, several studies on pregnancy in patients with acromegaly have been published in recent years adding new and relevant information to the preexisting literature. Also, new GH assays with selective specificities and the knowledge of the expression of the various GH genes have allowed a better understanding of somatotrophic axis function during pregnancy...
March 14, 2017: European Journal of Endocrinology
A Giustina, G Arnaldi, F Bogazzi, S Cannavò, A Colao, L De Marinis, E De Menis, E Degli Uberti, F Giorgino, S Grottoli, A G Lania, P Maffei, R Pivonello, E Ghigo
BACKGROUND: In 2007, we published an opinion document to review the role of pegvisomant (PEG) in the treatment of acromegaly. Since then, new evidence emerged on the biochemical and clinical effects of PEG and on its long-term efficacy and safety. AIM: We here reviewed the emerging aspects of the use of PEG in clinical practice in the light of the most recent literature. RESULTS: The clinical use of PEG is still suboptimal, considering that it remains the most powerful tool to control IGF-I in acromegaly allowing to obtain, with a pharmacological treatment, the most important clinical effects in terms of signs and symptoms, quality of life and comorbidities...
February 7, 2017: Journal of Endocrinological Investigation
Pedro W Rosario, Maria R Calsolari
Objective: To report the evolution of patients with a suggestive clinical scenario and elevated serum insulin-like growth factor-1 (IGF-1), but growth hormone (GH) suppression in the oral glucose tolerance test (OGTT), in whom acromegaly was not initially excluded. Subjects and methods: Forty six patients with a suggestive clinical scenario, who had elevated IGF-1 (outside puberty and pregnancy) in two measurements, but GH < 0.4 µg/L in the OGTT, were selected...
November 2016: Archives of Endocrinology and Metabolism
Kimberley Lambert, Kate Rees, Paul T Seed, Mandish K Dhanjal, Marian Knight, David R McCance, Catherine Williamson
OBJECTIVE: To examine the monitoring, management, and outcomes of pituitary tumors in pregnancy. METHODS: A national, prospective, observational, population-based case series study was conducted in all U.K. consultant-led obstetric units over 3 years using the U.K. Obstetric Surveillance System. To evaluate rates of adverse pregnancy outcomes, women with a macroprolactinoma (10 mm or greater) or nonfunctioning pituitary adenoma, diagnosed before or during pregnancy, were compared with two comparison groups: 1) a U...
January 2017: Obstetrics and Gynecology
Ammar Muhammad, Sebastian J Neggers, Aart J van der Lely
INTRODUCTION: Acromegaly is a rare disorder in which, due to the high incidence of secondary hypogonadism, pregnancies are relatively rare. However, some women with acromegaly do get pregnant, which brings along questions about medication, complications and follow-up. This review tries to address these issues and provide the reader with practical information. METHODS: This review summarizes published data. CONCLUSIONS: Acromegaly is a disorder that is characterized by changes in growth hormone (GH), insulin-like growth factor-1 (IGF-1) and insulin concentrations and actions...
February 2017: Pituitary
Angela Assal, Janine Malcolm, Heather Lochnan, Erin Keely
BACKGROUND AND AIMS: Approximately 174 pregnancies in acromegaly have been reported. Our objectives were to identify the key challenges of preconception counselling in this population. METHODS: Case series of three acromegalic women with desire for pregnancy. Issues were identified from chart review and discussion with attending physicians. Literature review of acromegaly and pregnancy was conducted. RESULTS: Important issues identified included: impact of acromegaly on fertility, management of acromegaly in the peripartum period, screening for associated conditions, risk of progression of acromegaly/tumour growth during pregnancy, impact of acromegaly on pregnancy outcomes, surveillance during pregnancy, method of delivery and impact on neonatal outcomes and breastfeeding...
March 2016: Obstetric Medicine
Ozlem Haliloglu, Burak Dogangun, Bahar Ozcabi, Hanife Ugur Kural, Fatma Ela Keskin, Hande Mefkure Ozkaya, Fatma Colkesen Pamukcu, Elif Bektas, Burc Cagri Poyraz, Hakan Buber, Olcay Evliyaoglu, Pinar Kadioglu
PURPOSE: To determine the physical status and intelligence scores of children of acromegalic mothers and to compare them with those of children from mothers without acromegaly. METHODS: Six women with acromegaly who became pregnant under follow-up between 2010 and 2014 and their 16 children (group A) were assessed and compared with 16 children of healthy women (group B) and 15 children of women with prolactinoma (group C). The physical examinations of children were performed by the department of pediatric endocrinology and intelligence quotient (IQ) testing was undertaken by adult and pediatric psychiatry departments, using appropriate scales for their ages...
August 2016: Pituitary
Andrea Glezer, Raquel S Jallad, Marcio C Machado, Maria C Fragoso, Marcello D Bronstein
Infertility is frequent in patients harboring pituitary adenomas. The mechanisms involved include hypogonadism secondary to hormonal hypersecretion (prolactin, growth hormone and cortisol), stalk disconnection and pituitary damage. With the improvement of clinical and surgical treatment, pregnancy in women harboring pituitary adenomas turned into a reality. Pituitary hormonal hyper- and hyposecretion influences pregnancy outcomes, as well as pregnancy can interfere on pituitary tumors, especially in prolactinomas...
September 2016: Minerva Endocrinologica
Bashir A Laway
With advances in surgical and medical treatment and the availability of assisted reproductive techniques, pregnancy in women with acromegaly is more frequently encountered. Diagnosis of acromegaly during pregnancy is difficult because of changes in growth hormone and insulin like growth factor-1 (IGF-1) axis secondary to placental production of growth hormone. The difficulty is compounded by the inability of routine hormone assays to detect placental growth hormone. In the majority of patients with acromegaly, pregnancy does not have an adverse effect on mother or fetus and pituitary mass does not increase in size...
December 2015: Therapeutic Advances in Endocrinology and Metabolism
Anne Gogny, Francis Fiéni
Aglepristone (RU 46534) is a competitive progesterone antagonist that is indicated for the treatment of various progesterone-dependent physiological or pathologic conditions. Aglepristone has proven to be an effective means of terminating pregnancy in most species. When used to induce parturition, aglepristone was effective in all cases in the bitch, cow, and goat, with no apparent adverse effects on neonatal health or milk production. When used to schedule an elective cesarean section, aglepristone treatment was deemed safe for dams and puppies, providing that the ovulation date had been accurately assessed at the time of breeding...
March 1, 2016: Theriogenology
Pelin Oktayoglu, Kemal Nas, Faruk Kilinç, Nebahat Tasdemir, Mehtap Bozkurt, Ismail Yildiz
INTRODUCTION: Carpal tunnel syndrome (CTS) is one of the most common entrapment neuropathies of the upper limbs. It results from compromised median nerve function of the wrist that is caused by increased pressure in the carpal tunnel. Repetitive use of the hand and wrist, obesity, pregnancy, rheumatoid diseases, trauma and endocrinopathies are some of the risk factors for CTS. AIM: The purpose of this study was to find out whether patients with diabetes mellitus (DM), hypothyroidism and acromegaly have an increased incidence of carpal tunnel syndrome compared to each other and normal population...
June 2015: Journal of Clinical and Diagnostic Research: JCDR
Mark A Sperling
Growth hormone has been known to be diabetogenic for almost a century and it's diabetogenic properties fostered consideration of excessive and abnormal GH secretion as a cause of diabetes, as well as a role in the microvascular complications, especially retinopathy. However, besides inducing insulin resistance, GH also is lipolytic and a major anabolic hormone for nitrogen retention and protein synthesis. These actions are best illustrated at the extremes of GH secretion: Gigantism/acromegaly is characterized by excessive growth, CHO intolerance, hyperplasia of bone, little body fat and prominent muscle development, whereas total deficiency of GH secretion or action is associated with adiposity, poor growth, and poor muscle development...
June 2016: Growth Hormone & IGF Research
Françoise Galland, Marie-Christine Vantyghem, Laure Cazabat, Anne Boulin, François Cotton, Jean-François Bonneville, Emmanuel Jouanneau, Gwénaelle Vidal-Trécan, Philippe Chanson
Prevalence of pituitary incidentaloma is variable: between 1.4% and 27% at autopsy, and between 3.7% and 37% on imaging. Pituitary microincidentalomas (serendipitously discovered adenoma <1cm in diameter) may increase in size, but only 5% exceed 10mm. Pituitary macroincidentalomas (serendipitously discovered adenoma>1cm in diameter) show increased size in 20-24% and 34-40% of cases at respectively 4 and 8years' follow-up. Radiologic differential diagnosis requires MRI centered on the pituitary gland. Initial assessment of nonfunctioning (NF) microincidentaloma is firstly clinical, the endocrinologist looking for signs of hypersecretion (signs of hyperprolactinemia, acromegaly or Cushing's syndrome), followed up by systematic prolactin and IGF-1 assay...
July 2015: Annales D'endocrinologie
Maria Fleseriu
No abstract text is available yet for this article.
August 2015: Endocrine
A J van der Lely, Roy Gomez, Joseph F Heissler, Ann-Charlotte Åkerblad, Peter Jönsson, Cecilia Camacho-Hübner, Maria Kołtowska-Häggström
To summarize all available data on pregnancy outcome of acromegaly patients exposed to the growth hormone receptor antagonist pegvisomant (PEGV) during pregnancy as present in the Pfizer's Global Safety Database. Pfizer's Global Safety Database contains adverse event data obtained from the following sources: spontaneous reports, health authorities, Pfizer-sponsored post-marketing surveillance program (ACROSTUDY), customer engagement programs, and clinical studies, reported regardless of outcome. The safety database was searched up to 10th March 2014...
August 2015: Endocrine
Ozlem Celik, Suleyman Engin Akhan, Esra Hatipoglu, Pinar Kadioglu
OBJECTIVE: To evaluate gynecological problems of female patients with acromegaly and the relationship of these problems with the activity of the disease. STUDY DESIGN: Thirty-four women with acromegaly and 27 age- and body mass index-matched female healthy controls (HC) were included in the study. Demographic features, medical history, hormonal status and disease activity were obtained. A detailed gynecological examination was performed. RESULTS: The incidence of pelvic organ prolapse (POP) was higher in patients with acromegaly (53%, n=18) compared to the HC (15%, n=4) (p=0...
December 2014: European Journal of Obstetrics, Gynecology, and Reproductive Biology
Laurence Katznelson, Edward R Laws, Shlomo Melmed, Mark E Molitch, Mohammad Hassan Murad, Andrea Utz, John A H Wass
OBJECTIVE: The aim was to formulate clinical practice guidelines for acromegaly. PARTICIPANTS: The Task Force included a chair selected by the Endocrine Society Clinical Guidelines Subcommittee (CGS), five experts in the field, and a methodologist. The authors received no corporate funding or remuneration. This guideline is cosponsored by the European Society of Endocrinology. EVIDENCE: This evidence-based guideline was developed using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system to describe both the strength of recommendations and the quality of evidence...
November 2014: Journal of Clinical Endocrinology and Metabolism
Ali Erdem Yildirim, Denizhan Divanlioglu, Nuri Eralp Cetinalp, Sevinc Sahin, Sezer Kulacoglu, Ahmed Deniz Belen
AIM: The authors review their experience in the endoscopic endonasal transsphenoidal treatment of 5 patients, finally diagnosed as primary hypophysitis but initially assumed to be pituitary adenomas. MATERIAL AND METHODS: A retrospective study was undertaken to review 5 cases of primary non-necrotizing granulomatous hypophysitis (1.61%) through 310 endoscopic transsphenoidally operated cases with the diagnosis of pituitary adenoma between 2009 and 2013. All 5 cases were female without any background of autoimmunity or recent pregnancy...
2014: Turkish Neurosurgery
Marie-Laure Persechini, Isabelle Gennero, Solange Grunenwald, Delphine Vezzosi, Antoine Bennet, Philippe Caron
INTRODUCTION: A decrease of insulin-like growth factor-I levels (IGF-I) has been reported during the first trimester of pregnancy in women with acromegaly before the secretion of placental growth hormone (GH) progressively increases IGF-1 concentration. STUDY DESIGN: To evaluate variations of concentrations of IGF-1, insulin-like growth factor (IGF)-binding protein-3 (IGF-BP3) and GH during the first trimester of pregnancy in women with normal somatotroph function...
August 2015: Pituitary
José Hernán Martínez, Carlos Figueroa-Núñez, Paola Mansilla-Letelier, Coromoto Palermo-Garofalo, Mónica Santiago, Oberto Torres, Rafael Trinidad, Michelle Mangual-García, Alfredo Sánchez, Madelin Gutierrez, María de Lourdes Miranda, Eva González
Pseudoacromegaly is a extremely rare condition previously described and characterized by acromegaloid changes, tissue overgrowth, without elevations in insulin-like growth factor or growth hormone as seen in Acromegaly. We present the case of a young female seen initially with acromegaloid features and a pituitary microadenoma. After work-up the patient was diagnosed as insulin-mediated pseudoacromegaly. Only a few cases of pseudoacromegaly has been reported and should always be considered when evaluating patients for acromegaloid features with negative biochemical and hormonal levels...
2014: Boletín de la Asociación Médica de Puerto Rico
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