Akromegaly and pharmacotherapy

Česká verzia

Authors: Helena Šiprová; Miroslav Souček
Authors place of work: II. interní klinika LF MU a FN u sv. Anny Brno, přednosta prof. MUDr. Miroslav Souček, CSc.
Published in the journal: Vnitř Lék 2015; 61(2): 157-160
Category: Case Report

Summary

Acromegaly is a rare and serious disease. A successful and rational therapy of acromegaly ought to combine surgery, radiotherapy and pharmacotherapy. The submitted article presents a case of acromegaly that was only diagnosed at the stage when total pituitary adenoma removal was impossible. Even so, the long-term stabilisation of the disease was reached by way of repeated surgery through transfenoidal and transcranial approach, by linear accelerator radiation therapy and Leksell Gamma Knife radiotherapy and by pharmacotherapy with somatostatin analogon octreotide and growth hormone receptor antagonist pegvisomant. The octreotide and pegvisomant dosage has been repeatedly changed according to IGF1 levels. The contemporary somatostatin analogon Sandostatin LAR 30 mg is given once every 3 weeks and the growth hormone receptor antagonist Somavert 20 mg is applied daily. Despite this serious disease, the patient has already been living contentedly for 10 years. From the ethical point of view, the financials costingness of the therapy should be considered as reasonable.

Key words:
acromegaly – insulin-like factor 1 – octreotide – pegvisomant – pharmacotherapy – pituitary adenoma

Zdroje

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