В статье представлена информация об акромегалии, освещены алгоритм диагностического поиска и лечебная тактика при выявлении данного заболевания у женщин репродуктивного возраста. На основании приведенного клинического случая описана врачебная тактика при ведении беременных с акромегалией. Ключевые слова: беременность, акромегалия, микроаденома гипофиза, соматотропинома, соматотропный гормон, октреопид.
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This article provides information on acromegaly, highlighting the diagnostic algorithm of search and therapeutic tactics in detecting the disease in women of reproductive age. Based on the above clinical case described medical tactics in the management of pregnant women with acromegaly. Key words: pregnancy, acromegaly, pituitary microadenoma, somatotropinoma, somatotropin hormone, octreopide.
1. Katznelson L, Jr. Laws ER, Melmed S et al. Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2014; 99: 3933.
2. Freda PU, Post KD, Powell JS, Wardlaw SL. Evaluation of disease status with sensitive measures of growth hormone secretion in 60 postoperative patients with acromegaly. J Clin Endocrinol Metab 1998; 83: 3808.
3. Dimaraki EV, Jaffe CA, DeMott-Friberg R et al. Acromegaly with apparently normal GH secretion: implications for diagnosis and follow-up. J Clin Endocrinol Metab 2002; 87: 3537.
4. Puder JJ, Nilavar S, Post KD, Freda PU. Relationship between disease-related morbidity and biochemical markers of activity in patients with acromegaly. J Clin Endocrinol Metab 2005; 90: 1972.
5. Swearingen B, Barker FG 2nd, Katznelson L et al. Long-term mortality after transsphenoidal surgery and adjunctive therapy for acromegaly. J Clin Endocrinol Metab 1998; 83: 3419.
6. Abosch A, Tyrrell JB, Lamborn KR et al. Transsphenoidal microsurgery for growth hormone-secreting pituitary adenomas: initial outcome and long-term results. J Clin Endocrinol Metab 1998; 83: 3411.
7. Ross DA, Wilson CB. Results of transsphenoidal microsurgery for growth hormone-secreting pituitary adenoma in a series of 214 patients. J Neurosurg 1988; 68: 854.
8. Fahlbusch R, Honegger J, Buchfelder M. Surgical management of acromegaly. Endocrinol Metab Clin North Am 1992; 21: 669.
9. Ben-Shlomo A, Melmed S. Clinical review 154: The role of pharmacotherapy in perioperative management of patients with acromegaly. J Clin Endocrinol Metab 2003; 88: 963.
10. Jr. Jane JA, Starke RM, Elzoghby MA et al. Endoscopic transsphenoidal surgery for acromegaly: remission using modern criteria, complications, and predictors of outcome. J Clin Endocrinol Metab 2011; 96: 2732.
11. Hofstetter CP, Mannaa RH, Mubita L et al. Endoscopic endonasal transsphenoidal surgery for growth hormone-secreting pituitary adenomas. Neurosurg Focus 2010; 29: E6.
12. Sze L, Schmid C, Bloch KE et al. Effect of transsphenoidal surgery on sleep apnoea in acromegaly. Eur J Endocrinol 2007; 156: 321.
13. Colao A, Marzullo P, Vallone G et al. Reversibility of joint thickening in acromegalic patients: an ultrasonography study. J Clin Endocrinol Metab 1998; 83: 2121.
14. Lamberts SW, Zweens M, Verschoor L, Del Pozo E. A comparison among the growth hormone-lowering effects in acromegaly of the somatostatin analog SMS 201-995, bromocriptine, and the combination of both drugs. J Clin Endocrinol Metab 1986; 63: 16.
15. Pradhananga S, Wilkinson I, Ross RJ. Pegvisomant: structure and function. J Mol Endocrinol 2002; 29: 11.
16. Cheng S, Grasso L, Martinez-Orozco JA et al. Pregnancy in acromegaly: experience from two referral centers and systematic review of the literature. Clin Endocrinol (Oxf) 2012; 76: 264.
17. Caron P, Broussaud S, Bertherat J et al. Acromegaly and pregnancy: a retrospective multicenter study of 59 pregnancies in 46 women. J Clin Endocrinol Metab 2010; 95: 4680.
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1. Katznelson L, Jr. Laws ER, Melmed S et al. Acromegaly: an endocrine society clinical practice guideline. J Clin Endocrinol Metab 2014; 99: 3933.
2. Freda PU, Post KD, Powell JS, Wardlaw SL. Evaluation of disease status with sensitive measures of growth hormone secretion in 60 postoperative patients with acromegaly. J Clin Endocrinol Metab 1998; 83: 3808.
3. Dimaraki EV, Jaffe CA, DeMott-Friberg R et al. Acromegaly with apparently normal GH secretion: implications for diagnosis and follow-up. J Clin Endocrinol Metab 2002; 87: 3537.
4. Puder JJ, Nilavar S, Post KD, Freda PU. Relationship between disease-related morbidity and biochemical markers of activity in patients with acromegaly. J Clin Endocrinol Metab 2005; 90: 1972.
5. Swearingen B, Barker FG 2nd, Katznelson L et al. Long-term mortality after transsphenoidal surgery and adjunctive therapy for acromegaly. J Clin Endocrinol Metab 1998; 83: 3419.
6. Abosch A, Tyrrell JB, Lamborn KR et al. Transsphenoidal microsurgery for growth hormone-secreting pituitary adenomas: initial outcome and long-term results. J Clin Endocrinol Metab 1998; 83: 3411.
7. Ross DA, Wilson CB. Results of transsphenoidal microsurgery for growth hormone-secreting pituitary adenoma in a series of 214 patients. J Neurosurg 1988; 68: 854.
8. Fahlbusch R, Honegger J, Buchfelder M. Surgical management of acromegaly. Endocrinol Metab Clin North Am 1992; 21: 669.
9. Ben-Shlomo A, Melmed S. Clinical review 154: The role of pharmacotherapy in perioperative management of patients with acromegaly. J Clin Endocrinol Metab 2003; 88: 963.
10. Jr. Jane JA, Starke RM, Elzoghby MA et al. Endoscopic transsphenoidal surgery for acromegaly: remission using modern criteria, complications, and predictors of outcome. J Clin Endocrinol Metab 2011; 96: 2732.
11. Hofstetter CP, Mannaa RH, Mubita L et al. Endoscopic endonasal transsphenoidal surgery for growth hormone-secreting pituitary adenomas. Neurosurg Focus 2010; 29: E6.
12. Sze L, Schmid C, Bloch KE et al. Effect of transsphenoidal surgery on sleep apnoea in acromegaly. Eur J Endocrinol 2007; 156: 321.
13. Colao A, Marzullo P, Vallone G et al. Reversibility of joint thickening in acromegalic patients: an ultrasonography study. J Clin Endocrinol Metab 1998; 83: 2121.
14. Lamberts SW, Zweens M, Verschoor L, Del Pozo E. A comparison among the growth hormone-lowering effects in acromegaly of the somatostatin analog SMS 201-995, bromocriptine, and the combination of both drugs. J Clin Endocrinol Metab 1986; 63: 16.
15. Pradhananga S, Wilkinson I, Ross RJ. Pegvisomant: structure and function. J Mol Endocrinol 2002; 29: 11.
16. Cheng S, Grasso L, Martinez-Orozco JA et al. Pregnancy in acromegaly: experience from two referral centers and systematic review of the literature. Clin Endocrinol (Oxf) 2012; 76: 264.
17. Caron P, Broussaud S, Bertherat J et al. Acromegaly and pregnancy: a retrospective multicenter study of 59 pregnancies in 46 women. J Clin Endocrinol Metab 2010; 95: 4680.
Авторы
С.А.Леваков, Е.И.Боровкова*, Е.А.Обухова
ГБОУ ВПО Первый Московский государственный медицинский университет
им. И.М.Сеченова Минздрава России. 119991, Россия, Москва, ул. Трубецкая, д. 8, стр. 2
*katyanikitina@mail.ru
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S.A.Levakov, E.I.Borovkova*, E.A.Obukhova
I.M.Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation. 119991, Russian Federation, Moscow, ul. Trubetskaia, d. 8, str. 2
*katyanikitina@mail.ru