A case of two consecutive deliveries in a woman with acromegaly / 대한내과학회지

ABSTRACT

Acromegaly is a rare pituitary disorder and usually results from GH hypersecretion by a somatotroph adenoma. Disturbed pituitary function might lead to infertility or early pregnancy termination. Pregnancy in acromegaly is very rare. GH is a potent insulin antagonist, and pregnant patients with GH hypersecretion are prone to added glucose intolerance and diabetes. Pregnancy itself may impact the course of a pituitary tumor. In our case, pregnancy was uneventful and normal full-term infant was delivered at 1993 by vaginal delivery after transsphenoidal surgery and bromocriptine therapy. After delivery, GH and IGF-I level wasn't normalized. Postoperative pituitary MRI scan showed residual tumor. Therefore she received subsequent postoperative pituitary radiation (total dose 5000 cGy). Next year, despite elevated GH and IGF-I, she delivered normal full-term infant. We report a case of two consecutive deliveries in a woman with acromegaly despite elevated GH and IGF-I levels after transsphenoidal surgery and radiation therapy.