Sustained clinical inactivity and stabilization of GH/IGF-1 levels in an acromegalic patient after discontinuation of somatostatin analogue treatment.
BACKGROUND
A 38-year-old woman first presented complaining of foot enlargement, finger numbness, arthralgia, fatigue, galactorrhoea and oligomenorrhea. Her symptoms in conjunction with her coarsened facial features and prognathism led to the suspicion of acromegaly.


METHODS
Oral glucose tolerance tests (OGTT) were performed at initial presentation and almost yearly thereafter for a period of 14 years. Pituitary computerized tomographies (CT) were performed annually for the first six years and magnetic resonance imaging every two years thereafter.


RESULTS
The diagnosis of acromegaly was confirmed by OGTT at presentation. A pituitary CT revealed a large invasive pituitary macroadenoma. She remained acromegalic after adenomectomy (evidently partial tumor resection), but was controlled with subsequent long-term somatostatin analogue (SRL) administration. After eight years of SRL administration, she had acceptable stabilization of acromegaly and at that point SRL administration was discontinued. The patient maintained the same control for the following six years up to the present time without further SRL administration.


CONCLUSIONS
This is the first case with stabilization of growth hormone (GH) and insulin-like growth factor-1 (IGF-1) to nearly normal levels and clinical inactivity of acromegaly after withdrawal of long-term treatment with SRLs.
Avramidis
Avraam
A
Department of Endocrinology, Hippokratio General Hospital, Thessaloniki, Greece.
Polyzos
Stergios A
SA
Efstathiadou
Zoe
Z
Kita
Marina
M
D000172:Acromegaly / Q000097:blood* / Q000188:drug therapy*; D000328:Adult; D004305:Dose-Response Relationship, Drug; D005260:Female; D005951:Glucose Tolerance Test; D013006:Growth Hormone / Q000097:blood*; D006728:Hormones / Q000627:therapeutic use; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism*; D013004:Somatostatin / Q000031:analogs & derivatives / Q000627:therapeutic use*
D006728:Hormones; D013004:Somatostatin; D007334:Insulin-Like Growth Factor I; D013006:Growth Hormone