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一名在孕期首次被诊断出的肢端肥大症女性。

An acromegalic woman first diagnosed in pregnancy.

作者信息

Hisano Michi, Sakata Mariko, Watanabe Noriyoshi, Kitagawa Michihiro, Murashima Atsuko, Yamaguchi Koushi

机构信息

Department of Perinatology, National Center for Child Health and Development, 2-10-1 Okura, Setagaya-ku, 157-8535 Tokyo, Japan.

出版信息

Arch Gynecol Obstet. 2006 Jun;274(3):171-3. doi: 10.1007/s00404-005-0114-y. Epub 2005 Dec 23.

Abstract

BACKGROUND

Reports of pregnancy in acromegalic women are uncommon, numbering less than 100, in which a case of acromegaly first diagnosed in pregnancy is rare.

CASE

A 40-year-old woman in 19-week gestation was presented with a 10-week history of photophobia and visual disturbance. Elevated growth hormone (GH) levels in the serum, an inadequate suppression of GH secretion with glucose administration and a mass image in the pituitary fossa confirmed the diagnosis of acromegaly. We initiated dopamine agonist treatment, bromocriptine at a weekly dose of 1 mg at 27-week gestation. Ten weeks after the start of the bromocriptine treatment, the GH levels gradually decreased to a normal range, and visual symptoms were improved. Enlargement of the tumor was not observed throughout the pregnancy and the patient delivered a healthy infant following an eventful pregnancy. At 3 weeks after delivery, she underwent a transsphenoidal resection of a pituitary adenoma.

CONCLUSION

Pregnancy may lead to pituitary tumor growth and increase the risk of developing loss of vision. It is important to take pituitary tumors into consideration when encountering gravida with visual disturbance.

摘要

背景

肢端肥大症女性怀孕的报道并不常见,病例数不足100例,其中孕期首次诊断为肢端肥大症的病例罕见。

病例

一名孕19周的40岁女性,有10周畏光和视觉障碍病史。血清生长激素(GH)水平升高、葡萄糖给药后GH分泌抑制不足以及垂体窝内有占位影像,确诊为肢端肥大症。我们在孕27周开始使用多巴胺激动剂治疗,每周服用1毫克溴隐亭。溴隐亭治疗开始10周后,GH水平逐渐降至正常范围,视觉症状改善。整个孕期未观察到肿瘤增大,患者经历了多事的孕期后产下一名健康婴儿。产后3周,她接受了垂体腺瘤经蝶窦切除术。

结论

怀孕可能导致垂体肿瘤生长并增加失明风险。遇到有视觉障碍的孕妇时,考虑垂体肿瘤很重要。

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