Pituitary Apoplexy After a Single Dose of Long-Acting Octreotide

Pituitary apoplexy causing spontaneous remission of acromegaly following long-acting octreotide therapy: a rare drug side effect or just a coincidence

“…Three cases of pituitary apoplexy with long-acting octreotide therapy in pituitary acromegaly have been reported. However, contrary to our case, all those three patients had predisposing risk factors for apoplexy [ 5 – 7 ]. One patient was on bromocriptine therapy, which was a risk factor for apoplexy in prolactinoma.…”

Pituitary apoplexy after somatostatin analogue administration: coincidental or causative?

“…However, Raivio's group recently described two unrelated men harbouring biallelic GNRHR mutations (R262Q/R262Q and R139H/R262Q, respectively) whose IHH reversed in their mid-20s, but then relapsed at ages 61 and 31 years, respectively. 5 We report two patients with atypical Kallmann's syndrome who initially appeared to 'recover' normal gonadotrophin secretion, consistent with reversal, but subsequently evidenced the requirement for periodic albeit infrequent, exposure to intramuscular testosterone undecanoate 1 g depot (TU, Nebido â ; Bayer AG, Leverkusen, Berlin) to maintain long-term GnRH neurosecretory axis integrity. In both cases, the injection interval was more than double the accepted duration of action.…”

“…1 Several risk factors have been reported, such as stimulation tests, anticoagulant therapy, surgery, hypertension, dopamine agonist given in prolactinoma, 2 or even octreotide in three cases of acromegaly. [3][4][5] To our knowledge, no case has ever been reported after the use of Lanreotide. Shortly after we had been made aware of such a case that was reported to our Reference Center for Rare Pituitary Diseases by colleagues from a different hospital in France, we observed a similar case in our centre.…”

“…4 The second case was a 51-year-old patient with acromegaly and severe hypertension who presented pituitary apoplexy after the first injection of long-acting octreotide. 5 The third case was mentioned in a large series of operated patients with Acromegaly, but no detail was available. 3 These four cases illustrate a possible rare side effect of SSA given in the treatment of acromegaly.…”

Cure of Acromegaly and Diabetes Mellitus After Pituitary Apoplexy

“…Pituitary apoplexy may be spontaneous or appear after medication intake (such as Bromocriptine, somatostatin analogs (14,15), anticoagulation therapy (16), clomiphene (17), pituitary tests, pregnancy (18), anesthesia, surgery, and viral meningitis (19). For our patient who was relatively young, the apoplexy seemed to be spontaneous, but we cannot totally rule out the role of insulin injections, tobacco and diabetes mellitus.…”