caa a22 4500 465805272 CHVBK 20180323112102.0 cr unu---uuuuu 170327e19900901xx s 000 0 eng 10.1007/BF03349598 doi (NATIONALLICENCE)springer-10.1007/BF03349598 Resistance to a long-acting somatostatin analog (SMS 201-995) reversed by surgery in acromegaly [Elektronische Daten] [Roberto Attanasio, P. Chiodini, A. Liuzzi, P. Orlandi, C. De Palo, D. Dallabonzana, A. Lodrini, R. Cozzi] A 42-year-old woman had acromegaly and a large macroadenoma with supra- and parasellar extension. Her GH levels (median 85 ng/ml, range 63-170 ng/ml) were not responsive to TRH (200 μg iv), GHRH (100 μg iv) and bromocriptine (Br 2.5 mg po) acute tests; Sm-C level was 8 U/ml. She was treated with octreotide (SMS) (up to 1500 μg daily) for 3 months. No changes of clinical, biochemical and radiological findings were seen, therefore she underwent transsphenoidal surgery. After surgery, hypopituitarism and diabetes insipidus appeared: GH levels remained high (median 45 ng/ml; range 37-56 ng/ml), but became responsive to Br acute test. The patient was given SMS again, and this resulted in clinical improvement, marked reduction of GH and Sm-C levels and slight shrinkage of the residual tumor. Speculative hypotheses about this previously unreported phenomenon might be either an excess of both GHRH and somatostatin, caused by a primary increase of dopaminergic tone, or a primary excess only of GHRH; in both cases the surgical lesion of the hypothalamic-pituitary region might have impaired the neurohormones inflow to the residual pituitary and so let SMS and Br exert their inhibitory actions on GH secretion. Italian Society of Endocrinology (SIE), 1990 Acromegaly nationallicence somatostatin nationallicence SMS 201-995 nationallicence bromocriptine nationallicence SMS resistance nationallicence Attanasio Roberto Divisione di Endocrinologia, Ospedale Niguarda, Piazza Ospedale Maggiore 3, I-20162, Milano, Italy aut Chiodini P. Divisione di Endocrinologia, Ospedale Niguarda, Piazza Ospedale Maggiore 3, I-20162, Milano, Italy aut Liuzzi A. Divisione di Endocrinologia, Ospedale Niguarda, Piazza Ospedale Maggiore 3, I-20162, Milano, Italy aut Orlandi P. Divisione di Endocrinologia, Ospedale Niguarda, Piazza Ospedale Maggiore 3, I-20162, Milano, Italy aut De Palo C. Divisione di Endocrinologia, Ospedale Niguarda, Piazza Ospedale Maggiore 3, I-20162, Milano, Italy aut Dallabonzana D. Divisione di Endocrinologia, Ospedale Niguarda, Piazza Ospedale Maggiore 3, I-20162, Milano, Italy aut Lodrini A. Divisione di Neurochirurgia, Istituto Neurologico C. Besta, Via Celoria 11, Milano, Italy aut Cozzi R. Divisione di Endocrinologia, Ospedale Niguarda, Piazza Ospedale Maggiore 3, I-20162, Milano, Italy aut Journal of Endocrinological Investigation Springer International Publishing 13/8(1990-09-01), 683-687 0391-4097 13:8<683 1990 13 40618 https://doi.org/10.1007/BF03349598 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/BF03349598 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Attanasio Roberto Divisione di Endocrinologia, Ospedale Niguarda, Piazza Ospedale Maggiore 3, I-20162, Milano, Italy aut NATIONALLICENCE 700 1- Chiodini P. Divisione di Endocrinologia, Ospedale Niguarda, Piazza Ospedale Maggiore 3, I-20162, Milano, Italy aut NATIONALLICENCE 700 1- Liuzzi A. Divisione di Endocrinologia, Ospedale Niguarda, Piazza Ospedale Maggiore 3, I-20162, Milano, Italy aut NATIONALLICENCE 700 1- Orlandi P. Divisione di Endocrinologia, Ospedale Niguarda, Piazza Ospedale Maggiore 3, I-20162, Milano, Italy aut NATIONALLICENCE 700 1- De Palo C. Divisione di Endocrinologia, Ospedale Niguarda, Piazza Ospedale Maggiore 3, I-20162, Milano, Italy aut NATIONALLICENCE 700 1- Dallabonzana D. Divisione di Endocrinologia, Ospedale Niguarda, Piazza Ospedale Maggiore 3, I-20162, Milano, Italy aut NATIONALLICENCE 700 1- Lodrini A. Divisione di Neurochirurgia, Istituto Neurologico C. Besta, Via Celoria 11, Milano, Italy aut NATIONALLICENCE 700 1- Cozzi R. Divisione di Endocrinologia, Ospedale Niguarda, Piazza Ospedale Maggiore 3, I-20162, Milano, Italy aut NATIONALLICENCE 773 0- Journal of Endocrinological Investigation Springer International Publishing 13/8(1990-09-01), 683-687 0391-4097 13:8<683 1990 13 40618 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer