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Suppression of GH secretion in pituitary gigantism by continuous subcutaneous octreotide infusion in a pubertal boy
Author(s) -
NäntöSalonen K,
Koskinen P,
Sonninen P,
Toppari J
Publication year - 1999
Publication title -
acta pædiatrica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.772
H-Index - 115
eISSN - 1651-2227
pISSN - 0803-5253
DOI - 10.1111/j.1651-2227.1999.tb01263.x
Subject(s) - octreotide , endocrinology , medicine , somatostatin , gigantism , acromegaly , somatotropic cell , prolactin , growth hormone , hormone
We describe a 12‐y‐old boy with excessive growth hormone and prolactin secretion presumably due to diffuse somatotroph hyperplasia. Until mid‐puberty, his growth rate was under reasonable control, with high‐dose octreotide injections every 8 h combined with a dopamine agonist. As his growth velocity started to increase, the efficacy of continuous s.c. octreotide infusion on GH secretion was tested. Similar total daily doses (600 μg) of octreotide were administered either by incremental s.c. injections at 8 h intervals, or by continuous s.c. infusion, two‐thirds of the amount during night‐time to control the presumed high nocturnal growth hormone (GH) peaks of the pubertal growth spurt. An overnight GH profile showed inadequate suppression of GH levels by incremental injections, while continuous s.c. infusion efficiently brought down the GH secretion. Another somatostatin analogue, lanreotide as a single depot injection was not effective. A 6‐mo trial on the s.c. infusion regimen significantly reduced growth hormone secretion (as judged by IGF‐I and IGFBP3 concentrations), and normalized growth velocity overcoming the pubertal growth spurt. It also caused a decrease in the pituitary size in magnetic resonance images. We conclude that the efficacy of octreotide infusion in suppressing GH secretion is superior to incremental injections with the same dose.