Pregnancy associated with recurrent acromegaly: a case report.
BACKGROUND
Acromegaly is an uncommon endocrine disorder. Pregnancy is an unusual event in acromegalic females because fertility is often reduced. With the advent of advanced surgical and medical management, more acromegalic women will achieve pregnancy. Reports of pregnancy in acromegaly and recurrent acromegaly postpartum are rare.


OBJECTIVE
To present a rare occurrence of pregnancy in acromegaly after macroadenectomy and recurrent acromegaly postpartum.


METHODS
Clinical and biochemical evaluation of a 39-year-old female Nigerian with features of acromegaly before and after macroadenectomy and postpartum was done. Investigations carried out included oral glucose tolerance test with serial growth hormone assays and insulin-like growth factor 1 as well as computed tomography scan and magnetic resonance imaging of the pituitary.


RESULTS
There was a history of menorrhagia, swelling of the feet and increasing coarsening of the facial appearance. She had biochemical evidence of acromegaly and subsequently had a transsphenoidal macroadenectomy. There was postoperative clinical and biochemical remission. Magnetic resonance imaging done six months postsurgery showed no evidence of tumour regrowth. Clinical and biochemical evidence of acromegaly recurred after pregnancy. Magnetic resonance imaging confirmed tumour regrowth.


CONCLUSIONS
Pregnancy in treated acromegaly, though a rare occurrence, is achievable but is capable of provoking recurrence of acromegaly.
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Department of Medicine, University of Benin Teaching Hospital, Benin City, P.M.B 1111, Benin City, Edo State, Nigeria. osayumen@yahoo.com
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D000172:Acromegaly / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D000328:Adult; D018931:Antineoplastic Agents, Hormonal / Q000627:therapeutic use; D001971:Bromocriptine / Q000627:therapeutic use; D005260:Female; D049912:Growth Hormone-Secreting Pituitary Adenoma / Q000473:pathology* / Q000601:surgery; D006727:Hormone Antagonists / Q000627:therapeutic use; D019382:Human Growth Hormone / Q000097:blood* / Q000378:metabolism; D006801:Humans; D007334:Insulin-Like Growth Factor I / Q000378:metabolism; D008279:Magnetic Resonance Imaging; D015282:Octreotide / Q000627:therapeutic use; D011247:Pregnancy; D011248:Pregnancy Complications / Q000473:pathology* / Q000601:surgery; D011256:Pregnancy Outcome; D012008:Recurrence; D016896:Treatment Outcome
D018931:Antineoplastic Agents, Hormonal; D006727:Hormone Antagonists; D019382:Human Growth Hormone; D001971:Bromocriptine; D007334:Insulin-Like Growth Factor I; D015282:Octreotide