Detecting and solving the interference of pregnancy serum, in a GH immunometric assay

Rodrigues, Monike Lourenço Dias; Vieira, José Gilberto H.; Abucham, Júlio

doi:10.1016/j.ghir.2012.11.001

Cited by 19 publications

(26 citation statements)

References 27 publications

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“…Intra-assay CV were !2.9% and interassay CV were !7.5%. Crossreactivity studies with two commercially available nonglycosylated human placental GH (pGH) isoforms were !0.001% for both 20K and 22K pGH in that assay (11).…”

Section: Hormonal Measurementsmentioning

confidence: 73%

“…GH assays during pregnancy " Initially (pregnancies A1-D5), GH was only measured by a GH assay, which showed an unusual negative interference, as we reported elsewhere (11,19). Therefore, valid GH measurements could not be obtained in those five patients during pregnancy.…”

Section: Hormonal Measurementsmentioning

confidence: 85%

“…Therefore, valid GH measurements could not be obtained in those five patients during pregnancy. In the last pregnancies (D6-H10) and in controls, GH was measured using a recently developed interference-free immunofluorometric GH assay validated to measure serum GH level during pregnancy and pegvisomant treatment (11). Intra-assay CV were !2.9% and interassay CV were !7.5%.…”

Section: Hormonal Measurementsmentioning

confidence: 99%

“…Hormonal assessment of acromegaly during pregnancy is challenging. Interference of circulating placental hormones with homology to pituitary GH can often lead to either falsely elevated (10) or suppressed GH values in GH assays (11). Also, usual reference ranges for both basal and post glucose GH as well as for insulin-like growth factor 1 (IGF1) levels cannot be applied to pregnant women, as GH levels decline and IGF1 levels increase during normal pregnancy (12).…”

Section: Introductionmentioning

confidence: 99%

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Acromegaly and pregnancy: a prospective study

Rodrigues¹,

Boguszewski²,

Gadelha³

et al. 2014

European Journal of Endocrinology

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Context and objective: The interaction between pregnancy and acromegaly has been studied only retrospectively. We used prospective data to assess those interactions. Design: Prospective, interventional, multicentric study. Patients: Ten pregnancies in eight acromegalic patients were included according to the following criteria: previous diagnosis of acromegaly; and active acromegaly before pregnancy. Sellar magnetic resonance image (MRI), GH, and IGF1 measurements were carried out before pregnancy. The exclusion criterion was radiotherapy. Intervention: Withdrawal of pharmacological treatment (octreotide and/or cabergoline and/or pegvisomant) following pregnancy diagnosis. Main outcome measures: Clinical/biochemical evaluations throughout pregnancy/puerperium and sellar MRI after delivery; and GH and IGF1 measurements before pregnancy. GH was measured by an interference-free IFMA assay during pregnancy and IGF1 by measured by Immulite 2000 assay in patients and 64 control pregnancies. Results: No tumor growth was observed. Nine deliveries were at term and one at 35 weeks (preeclampsia). All newborns were healthy. Mean IGF1 levels before and during pregnancy were similar, but increased significantly during puerperium. As IGF1 in controls increased after midgestation, the prevalence of controlled IGF1 rose significantly from 2/10 (!20 weeks) to 9/10 (O30 weeks). Diabetes mellitus and hypertension/preeclampsia developed in one patient in each group; both complications were nonsignificantly (PZ0.06) associated with IGF1 O1.3 ULN before pregnancy. Conclusions: Acromegaly control usually improved and tumor growth was not stimulated during pregnancy in spite of withdrawal of drug treatment. Drug treatment can be discontinued in most patients. Uncontrolled disease before pregnancy may pose a higher risk for diabetes and hypertension.

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Section: Hormonal Measurementsmentioning

confidence: 73%

Section: Hormonal Measurementsmentioning

confidence: 85%

Section: Hormonal Measurementsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Acromegaly and pregnancy: a prospective study

Rodrigues¹,

Boguszewski²,

Gadelha³

et al. 2014

European Journal of Endocrinology

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“…As a result, single-center case series (2) and multicenter retrospective (3,4) and prospective studies (5) on pregnancy in patients with acromegaly that have been published in recent years have added new and relevant information to the preexisting literature (6,7). Moreover, the development of GH immunoassays with selective specificities (8,9) and the increasing knowledge of the expression of the various genes (10,11) have allowed substantial improvement in our understanding of the changes in the somatotrophic axis that take place during pregnancy.…”

Section: Introductionmentioning

confidence: 99%

MANAGEMENT OF ENDOCRINE DISEASE: Acromegaly and pregnancy: a contemporary review

Abucham

Bronstein

Rodrigues

2017

European Journal of Endocrinology

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Although fertility is frequently impaired in women with acromegaly, pregnancy is apparently becoming more common due to improvement in acromegaly treatment as well as in fertility therapy. As a result, several studies on pregnancy in patients with acromegaly have been published in recent years adding new and relevant information to the preexisting literature. Also, new GH assays with selective specificities and the knowledge of the expression of the various GH genes have allowed a better understanding of somatotrophic axis function during pregnancy. In this review, we show that pregnancy in women with acromegaly is generally safe, usually with tumoral and hormonal stability. Although the paucity of data limits evidence-based recommendations for preconception counseling and pregnancy surveillance, controlling tumor size and hormonal activity before pregnancy is highly recommended to ensure better outcomes, and surgical control should be attempted when feasible. Treatment interruption at pregnancy confirmation has also proven to be safe, as drugs are not formally allowed to be used during pregnancy. Drug exposure (somatostatin analogs) during early or whole pregnancy might increase the chance of a lower birth weight. Aggressive disease is uncommon and may urge individual decisions such as surgery or drug treatment during pregnancy or lactation.Correspondence should be addressed to J Abucham

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Pregnancy and acromegaly

2016

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IntroductionAcromegaly is a rare disorder in which, due to the high incidence of secondary hypogonadism, pregnancies are relatively rare. However, some women with acromegaly do get pregnant, which brings along questions about medication, complications and follow-up. This review tries to address these issues and provide the reader with practical information.MethodsThis review summarizes published data.ConclusionsAcromegaly is a disorder that is characterized by changes in growth hormone (GH), insulin-like growth factor-1 (IGF-1) and insulin concentrations and actions. All these hormones are important in pregnancy as well. In principle, the fetal-placental collaboration between mother and child more-or-less takes over the control over GH and IGF-1, not only in normal physiology but also to a certain extend in acromegaly. When medication for the high GH levels or actions is continued during pregnancy, both dopamine agonists, somatostatin analogs and GH receptor antagonists have been used and the available data suggest that there are no adverse consequences on mother or fetus to date. However, it is strongly advised to stop any medical intervention during pregnancy until more data are available on the safety of these compounds. Also, medical treatment is not needed as tumor size and disease activity are not reported to escape.

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Detecting and solving the interference of pregnancy serum, in a GH immunometric assay

Cited by 19 publications

References 27 publications

Acromegaly and pregnancy: a prospective study

Acromegaly and pregnancy: a prospective study

MANAGEMENT OF ENDOCRINE DISEASE: Acromegaly and pregnancy: a contemporary review

Pregnancy and acromegaly

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