Acromégalie et grossesse

Diseases of the osteoarticular system; Pituitary diseases; Endocrinopathy; Adenohypophyseal hormone; Human; Acromegaly; Maternal diseases; Review; Complication; Fertility; Pregnancy; Somatotropin hormone; Système ostéoarticulaire pathologie; Hypophyse pathologie; Endocrinopathie; Hormone adénohypophysaire; Homme; Acromégalie; Mère pathologie; Article synthèse; Fertilité; Gestation; STH

Abstract :

[en] Acromegaly usually results from GH hypersecretion by a somatotroph adenoma. The fertility of acromegalic patients is often impaired. Several factors may impact the course of pregnancy in acromegaly. Disturbed pituitary function might lead to infertility or spontaneous abortion. GH is a powerful insulin antagonist, and pregnant acromegalic patients are prone to added glucose intolerance and diabetes. Pregnancy itself might also impact the course of the pituitary tumor. During pregnancy, the normal pituitary increases in size due to estrogens-mediated hyperplasia. Therefore, tumors are at risk for hemorrhage due to enhanced vascularity, and might compress the optic chiasm. In this article we summarize the data on the literature on the reciprocal influences between acromegaly and pregnancy, we discuss therapeutic options and advance diagnostic and surveillance schedules of acromegaly during pregnancy.
[fr] L'acromégalie est caractérisée par l'hypersécrétion de l'hormone de croissance hypophysaire (GH). La fertilité des patientes acromégales est souvent réduite. Plusieurs facteurs peuvent entraver le décours d'une grossesse chez une femme acromégale. La perturbation des fonctions hypophysaires peut aboutir à l'infertilité, voire à des avortements spontanés. La GH est un puissant antagoniste de l'insuline et les patientes acromégales enceintes sont prédisposées à l'intolérance aux hydrates de carbone et au diabète. La grossesse en soi, peut influencer l'évolution de l'adénome hypophysaire. Pendant la grossesse, l'hypophyse normale s'hyperplasie sous l'influence des œstrogènes. Dès lors, il existe un risque d'hémorragie tumorale due à l'hypervascularisation ainsi que de compression chiasmatique. Dans cet article nous résumons les données de la littérature concernant les influences réciproques entre l'acromégalie et la grossesse, exposons les options thérapeutiques et proposons un schéma diagnostic et de surveillance de l'acromégalie pendant la grossesse.

Disciplines :

Endocrinology, metabolism & nutrition

Author, co-author :

Betea, Daniela ; Centre Hospitalier Universitaire de Liège - CHU > Endocrinologie clinique

Valdes Socin, Hernan Gonzalo ; Centre Hospitalier Universitaire de Liège - CHU > Endocrinologie clinique

Hansen, Isabelle ; Université de Liège - ULiège > Neurologie Sart Tilman

Stevenaert, Achille ; Université de Liège - ULiège > Neurochirurgie

Beckers, Albert ; Université de Liège - ULiège > Département des sciences cliniques > Endocrinologie

Language :

French

Title :

Acromégalie et grossesse

Alternative titles :

[en] Acromegaly and Pregnancy

Publication date :

October 2002

Journal title :

Annales d'Endocrinologie

ISSN :

0003-4266

eISSN :

2213-3941

Publisher :

Masson, Moulineaux Cedex 9, France

Volume :

Issue :

Pages :

457-63

Peer reviewed :

Peer Reviewed verified by ORBi

Available on ORBi :

since 19 May 2010

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