An acromegalic woman first diagnosed in pregnancy.
BACKGROUND
Reports of pregnancy in acromegalic women are uncommon, numbering less than 100, in which a case of acromegaly first diagnosed in pregnancy is rare.


METHODS
A 40-year-old woman in 19-week gestation was presented with a 10-week history of photophobia and visual disturbance. Elevated growth hormone (GH) levels in the serum, an inadequate suppression of GH secretion with glucose administration and a mass image in the pituitary fossa confirmed the diagnosis of acromegaly. We initiated dopamine agonist treatment, bromocriptine at a weekly dose of 1 mg at 27-week gestation. Ten weeks after the start of the bromocriptine treatment, the GH levels gradually decreased to a normal range, and visual symptoms were improved. Enlargement of the tumor was not observed throughout the pregnancy and the patient delivered a healthy infant following an eventful pregnancy. At 3 weeks after delivery, she underwent a transsphenoidal resection of a pituitary adenoma.


CONCLUSIONS
Pregnancy may lead to pituitary tumor growth and increase the risk of developing loss of vision. It is important to take pituitary tumors into consideration when encountering gravida with visual disturbance.
Hisano
Michi
M
Department of Perinatology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, 157-8535 Tokyo, Japan. hisano-m@ncchd.go.jp
Sakata
Mariko
M
Watanabe
Noriyoshi
N
Kitagawa
Michihiro
M
Murashima
Atsuko
A
Yamaguchi
Koushi
K
D000172:Acromegaly / Q000175:diagnosis* / Q000209:etiology; D000236:Adenoma / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D000328:Adult; D001971:Bromocriptine / Q000627:therapeutic use; D018491:Dopamine Agonists / Q000627:therapeutic use; D005260:Female; D006801:Humans; D009897:Optic Chiasm / Q000473:pathology; D019574:Optic Nerve Neoplasms / Q000175:diagnosis* / Q000628:therapy; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000628:therapy; D011247:Pregnancy; D011252:Pregnancy Complications, Neoplastic / Q000175:diagnosis* / Q000628:therapy; D014786:Vision Disorders / Q000209:etiology
D018491:Dopamine Agonists; D001971:Bromocriptine