Eight-year follow-up of a child with a GH/prolactin-secreting adenoma: Efficacy of pegvisomant therapy

S. Bergamaschi, C. L. Ronchi, C. Giavoli, E. Ferrante, E. Verrua, D. I. Ferrari, A. Lania, R. Rusconi, A. Spada, P. Beck-Peccoz

Research output: Contribution to journalArticlepeer-review

Abstract

A 3.4-year-old girl was admitted to the Pediatric Department because of tall stature (116.0 cm, +5.1 SDS) and increased height velocity (16.3 cm/year, +6.1 SDS). Basal hormonal evaluation revealed elevated insulin-like growth factor I (IGF-I) levels (938 ng/ml, nv 40-190), prolactin (PRL) (98.0 ng/ml, nv 1.7-24.0) and mean growth hormone (GH) nocturnal concentration (147 ng/ml). Basal adrenal, gonadal and thyroid functions were normal. Hand-wrist bone age was 3.6 years. Magnetic resonance imaging revealed a macroadenoma with moderate suprasellar invasion. The adenoma was surgically removed and histological characterization confirmed the diagnosis of GH/PRL-secreting adenoma. The patient was admitted to our Endocrine Unit when 7.9 years old, because of the persistence of elevated GH, IGF-I and PRL levels, although there was a slight height velocity reduction and absence of tumor recurrence. Treatment with cabergoline was initiated, but only PRL levels normalized. Afterwards, octreotide long-acting release (LAR) was added without reaching the normalization of GH and IGF-I levels. Thus, treatment with octreotide LAR was discontinued and pegvisomant was added to cabergoline, leading to the normalization of IGF-I levels and height velocity without side effects. Other anterior pituitary functions were always normal. To conclude, treatment of pituitary gigantism with pegvisomant was effective and well tolerated in a young giant unresponsive to combined cabergoline and octreotide treatment.

Original languageEnglish
Pages (from-to)74-79
Number of pages6
JournalHormone Research in Paediatrics
Volume73
Issue number1
DOIs
Publication statusPublished - Jan 2010

Keywords

  • Gigantism
  • Growth hormone
  • Insulin-like growth factor I
  • Pegvisomant
  • Pituitary adenoma

ASJC Scopus subject areas

  • Endocrinology
  • Endocrinology, Diabetes and Metabolism
  • Pediatrics, Perinatology, and Child Health

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