Octreotide and bromocriptine suppress thyroid hormone levels and thyroid nodule in an acromegalic patient with nontoxic autonomous goiter.
An acromegalic patient with nontoxic autonomous goiter was sequentially treated with octreotide and bromocriptine. Before therapy, serum GH, PRL and insulin-like growth factor-I (IGF-I) levels were increased. Free T3 and free T4 were within the normal range with suppressed TSH levels, whereas 123Iodine-uptake of thyroid was 5.6% after 24 h. During treatment with octreotide and bromocriptine, serum GH, PRL, and IGF-I became normal and free T3 and free T4 were slightly but significantly decreased, but TSH levels remained very low. After thyroidectomy, thyroglobulin, free T3 and free T4 were further decreased, and the TSH levels were recovered to normal. These findings suggested that octreotide and bromocriptine inhibit the release of thyroid hormones from the autonomous thyroid gland directly or indirectly through the decline in IGF-I.
Sakane
N
N
First Department of Internal Medicine, Kyoto Prefectural University of Medicine, Japan.
Yoshida
T
T
Shimatsu
A
A
Umekawa
T
T
Kondo
M
M
D000172:Acromegaly / Q000188:drug therapy* / Q000503:physiopathology; D001971:Bromocriptine / Q000627:therapeutic use*; D005260:Female; D006044:Goiter, Nodular / Q000188:drug therapy* / Q000503:physiopathology; D019382:Human Growth Hormone / Q000378:metabolism; D006801:Humans; D008875:Middle Aged; D015282:Octreotide / Q000627:therapeutic use*; D013960:Thyroid Function Tests
D019382:Human Growth Hormone; D001971:Bromocriptine; D015282:Octreotide