Professional paper
Decrease in Growth Hormone and Insulin-like Growth Factor (IGF) - 1 Release and Amelioration of Acromegaly Features after Rosiglitazone Treatment of Type 2 Diabetes Mellitus in a Patient with Acromegaly
Marina Gradišer
Martina Matovinović
Milan Vrkljan
Abstract
A 28-year-old woman with clinical features of acromegaly and diabetes mellitus was admitted to our Reference Center for Clinical Neuroendocrinology and Pituitary Diseases at Sisters of Mercy University Hospital, Zagreb. A magnetic resonance scan of the brain showed a pituitary macroadenoma. After transsphenoidal resection, histological analysis confirmed it was a growth hormone (GH)-secreting pituitary adenoma. The tumor could not be completely removed, but the hormonal status normalized. A month after the surgery, octreotide was introduced because of further increase of GH and insulin like growth factor- I (IGF-I), but discontinued after a week due to intolerance. Alternative treatment with oral antidiabetic agent, rosiglitazone, was introduced two weeks after octreotide was discontinued, and the fasting blood glucose concentration decreased from 8.4 mmol/L before the treatment to 6.7 mmol/L after 90 days of treatment. The concentration of GH and insulin-like growth factor I (IGF-I) of 5.96 ng/mL and 990 ng/mL, respectively, in the week before rosiglitazone was introduced decreased to 2.92 ng/mL and 180.0 ng/mL after 90 days of treatment. There was also a pronounced improvement in acromegalic features. It is possible that rosiglitazone induced the decrease in GH and IGF-I concentrations and its role in the long-term medical therapy of patients with pituitary tumors should be further investigated.
Keywords
pituitary tumor; acromegaly; peroxisome proliferator activated receptor-gamma; growth hormone; insulin-like growth hormone I; diabetes mellitus
Hrčak ID:
9417
URI
Publication date:
20.2.2007.
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