ometendoОжирение и метаболизмObesity and metabolism2071-87132306-5524Endocrinology Research Centre10.14341/omet12960ometendo-12998Research ArticleКЛИНИЧЕСКИЕ СЛУЧАИCASE REPORTSЭффективность терапии октреотидом пролонгированного действия у пациентки с акромегалией в качестве первичного леченияEfficacy of long-term octreotide therapy of acromegaly as the first-line medical treatmenthttps://orcid.org/0000-0002-0327-4619ДзерановаЛ. К.DzeranovaL. K.

Дзеранова Лариса Константиновна, доктор медицинских наук

Москва

 

Larisa K. Dzeranova, MD, PhD

 

dzeranovalk@yandex.ruhttps://orcid.org/0000-0001-6009-9872ЕвлоеваМ. И.YevloyevaM. I.

Евлоева Мадина Иссаевна

г. Москва, ул. Дмитрия Ульянова, д. 11, 117036

 

Madina I. Yevloyeva, MD

Moscow, Dmitry Ulyanov street, 11, 117036

 

madevis_6@mail.ruhttps://orcid.org/0000-0001-5824-6490ПерепеловаМ. А.PerepelovaM. A.

Перепелова Маргарита Александровна

Москва

 

Margarita A. Perepelova, MD

Moscow

 

margo.doktor@mail.ruhttps://orcid.org/0000-0001-6539-466XПигароваЕ. А.PigarovaE. A.

Пигарова Екатерина Александровна, доктор медицинских наук

Москва

 

Ekaterina A. Pigarova, MD, PhD

Moscow

 

kpigarova@gmail.comhttps://orcid.org/0000-0003-0047-7223ШутоваА. С.ShutovaA. S.

Шутова Александра Сергеевна

Москва

 

Aleksandra S. Shutova, MD

Moscow

shutova.aleksandra@gmail.comhttps://orcid.org/0000-0001-5724-6763ДоровскихА. В.DorovskikhA. V.

Доровских Анна Владимировна

Москва

 

Anna V. Dorovskikh, MD

Moscow

 

a.v.dorovskikh@gmail.comhttps://orcid.org/0000-0001-9718-6099АзизянВ. Н.AzizyanV. N.

Азизян Вилен Неронович, кандидат медицинских наук

Москва

 

Vilen N. Azyan, MD, PhD

Moscow

 

vazizyan@mail.ruhttps://orcid.org/0000-0001-9119-2447ПржиялковскаяЕ. Г.PrzhiyalkovskayaE. G.

Пржиялковская Елена Георгиевна, кандидат медицинских наук

Москва

 

Elena G. Przhiyalkovskaya, MD, PhD

Moscow

 

przhiyalkovskaya.elena@gmail.comНациональный медицинский исследовательский центр эндокринологииРоссияEndocrinology Research CentreRussian Federation2023230520232016672Copyright © Дзеранова Л.К., Евлоева М.И., Перепелова М.А., Пигарова Е.А., Шутова А.С., Доровских А.В., Азизян В.Н., Пржиялковская Е.Г., 20232023Дзеранова Л.К., Евлоева М.И., Перепелова М.А., Пигарова Е.А., Шутова А.С., Доровских А.В., Азизян В.Н., Пржиялковская Е.Г.Dzeranova L.K., Yevloyeva M.I., Perepelova M.A., Pigarova E.A., Shutova A.S., Dorovskikh A.V., Azizyan V.N., Przhiyalkovskaya E.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.omet-endojournals.ru/jour/article/view/12998

Акромегалия — тяжелое нейроэндокринное заболевание, характеризующееся гиперсекрецией гормона роста (ГР, синоним: соматотропный гормон), вызванное в 95% случаев аденомой гипофиза, что приводит к развитию патологии различных органов и систем. Тяжесть состояния обусловлена не только непосредственным воздействием ГР на организм и влиянием аденомы на окружающие структуры, но также возрастом пациента и осложнениями на фоне заболевания. Усовершенствование методов лечения позволяет применять персонализированный подход к ведению пациента, учитывая различные аспекты клинического случая. Для специалиста важно учитывать коморбидность при акромегалии как с точки зрения патологических нарушений, так и влияния на психоэмоциональное состояние пациента. Нами представлен клинический случай успешного лечения аналогами соматостатина (АСС) пациентки, испытывающей страх перед оперативным вмешательством и имеющей сердечно-сосудистые осложнения акромегалии. Пациентке с момента дебюта акромегалии, подтвержденной повышенным уровнем инсулиноподобного фактора роста 1 и наличием эндоселлярной макроаденомы гипофиза размерами 11х9,5х8 мм, инициирована терапия отечественными АСС. Выбор в пользу консервативного лечения был обусловлен отягощенным сердечно-сосудистым анамнезом и страхом пациентки перед оперативным вмешательством. В течение 3 лет с момента начала медикаментозной терапии отмечались значительное улучшение общего самочувствия, тенденция к уменьшению размеров аденомы гипофиза, достигнута биохимическая ремиссия. Описанный нами клинический случай подтверждает возможность успешного первичного лечения АСС у пациентки с акромегалией, учитывая все индивидуальные особенности.

Acromegaly is a severe neuroendocrine disease characterized by hypersecretion of growth hormone (GH) caused in 95% of cases by pituitary adenoma, which leads to the development of pathology of various organs and systems. The severity of the condition is due not only to the direct effect of somatotropic hormone on the body and the effect of the adenoma on the surrounding structures, but also to the age of the patient and complications associated with the disease. Improvement in treatment methods allows for a personalized approach to patient management, taking into account various aspects of the clinical case. It is important for a specialist to take into account comorbidity in acromegaly, both in terms of pathological disorders and the impact on the patient’s psycho-emotional state. We present a clinical case of successful treatment with somatostatin analogues (ASS) in a patient who is afraid of surgery and has cardiovascular complications of acromegaly. Since the onset of acromegaly, confirmed by an elevated level of insulin-like growth factor-1 (IGF-1) and an endosellar pituitary macroadenoma measuring 11x9.5x8 mm, ASS therapy was initiated in the patient. The choice in favor of conservative treatment was due to a burdened cardiovascular history and the patient’s fear of surgery. Within three years from the start of drug therapy, there was a significant improvement in overall well-being, a tendency to reduce the size of the pituitary adenoma, and biochemical remission was achieved. The clinical case described by us confirms the possibility of successful primary treatment of ASS in a patient with acromegaly, taking into account all individual characteristics.

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The authors declare that there are no conflicts of interest present.