Pregnancy Associated with Recurrent Acromegaly: A Case Report

Abstract

BACKGROUND: Acromegaly is an uncommon endocrine disorder. Pregnancy is an unusual event in acromegalic females because fertility is often reduced. With the advent of advanced surgical and medical management, more acromegalic women will achieve pregnancy. Reports of pregnancy in acromegaly and recurrent acromegaly postpartum are rare.
OBJECTIVE: To present a rare occurrence of pregnancy in acromegaly after macroadenectomy and recurrent acromegaly postpartum.
METHODS: Clinical and biochemical evaluation of a 39-year old female Nigerian with features of acromegaly before and after macroadenectomy and postpartum was done. Investigations carried out included oral glucose tolerance test with serial growth hormone assays and insulin-like growth
factor 1 as well as computed tomography scan and magnetic resonance imaging of the pituitary.
RESULTS: There was a history of menorrhagia, swelling of the feet and increasing coarsening of the facial appearance. She had biochemical evidence of acromegaly and subsequently had a transsphenoidal macroadenectomy. There was postoperative clinical and biochemical remission. Magnetic resonance imaging done six months postsurgery showed no evidence of tumour regrowth. Clinical and biochemical evidence of acromegaly recurred after pregnancy. Magnetic resonance
imaging confirmed tumour regrowth.
CONCLUSION: Pregnancy in treated acromegaly, though a rare occurrence, is achievable but is capable of provoking recurrence of acromegaly.