scholarly journals Long term treatment of a thyrotropin-secreting microadenoma with somatostatin analogues

2010 ◽  
Vol 54 (5) ◽  
pp. 502-506 ◽  
Author(s):  
Alma Prieto-Tenreiro ◽  
Patricia Díaz-Guardiola
Keyword(s):  
Pituitary Adenomas ◽  
Somatostatin Analogs ◽  
Somatostatin Analogues ◽  
Term Treatment ◽  
Somatostatin Analogue ◽  
Delay In Diagnosis ◽  
First Line Therapy ◽  
Long Term Treatment ◽  
Primary Hyperthyroidism

Thyrotropin (TSH) secreting pituitary adenomas (TSH-omas) account for < 1% of all pituitary adenomas and are a rare cause of hyperthyroidism. The diagnosis is often made at the stage of macroadenoma because of the aggressive nature of the tumor and due to the fact that patients are mistakenly treated for more common primary hyperthyroidism for a long time. First line therapy is transsphenoidal resection of the tumor, which can cure one-third of the patients completely. However, if surgery is not possible or curative, pituitary radiotherapy and/or somatostatin analogs (SSA) can be useful. We report the case of a 54-year-old woman treated 20 years earlier for a mistakenly suspected primary hyperthyroidism. Given the persistence of symptoms she was studied further and was diagnosed with a thyrotropinoma. Despite the delay in diagnosis and prior thyroid ablation, a microadenoma was found. As transsphenoidal surgery was not considered effective, medical therapy with a somatostatin analogue was initiated. Currently, at four years of follow-up, the patient continues on this treatment and remains euthyroid and asymptomatic. We report a case of successful long-term treatment with SSA, after unsuccessful surgery.

scholarly journals Long-term management in five cases of TSH-secreting pituitary adenomas: a single center study and review of the literature

2007 ◽  
Vol 157 (1) ◽  
pp. 39-46 ◽  
Author(s):  
Tina Kienitz ◽  
Marcus Quinkler ◽  
Christian J Strasburger ◽  
Manfred Ventz
Keyword(s):  
Pituitary Adenomas ◽  
Pituitary Tumor ◽  
Somatostatin Analogs ◽  
Pituitary Tumors ◽  
Term Treatment ◽  
Dopaminergic Agonists ◽  
Pituitary Mass ◽  
Long Term Treatment ◽  
Age Range

Objective: TSH-secreting pituitary tumors (TSH-omas) are a rare cause of hyperthyroidism and account for <1% of all pituitary adenomas. Failure to recognize the presence of a TSH-oma may result in dramatic consequences such as thyroid ablation that may cause further growth in pituitary tumor. The primary goal of the treatment of TSH-omas is to remove the pituitary tumor. Medical treatment includes dopaminergic agonists or somatostatin analogs. Methods and results: We report five cases of TSH-oma diagnosed between 1997 and 2006 and review the literature. All the patients are females with an age range from 54 to 65 years at diagnosis. Four of the five patients had at least one event of thyroid surgery due to goiter or nodule of unknown dignity. Three of the five patients had a stroke before the diagnosis of TSH-oma, probably due to hypertension, or smoking and contraceptive treatment. One patient with invasive tumor growth received stereotactic radiotherapy (and developed panhypopituitarism after operation), another patient received somatostatin analogs preoperatively and successfully underwent transsphenoidal operation. Three of the five patients received dopaminergic agonists (bromocriptine 5 mg daily or cabergoline 0.5–0.75 mg per week), because they refused surgical therapy or the tumor was stable under dopaminergic therapy. All patients have been followed-up for 2.5–8 years. A normalization of circulating thyroid hormone levels was achieved in all patients. The patient who underwent operation shows no recurrence of the disease. The other patients have a stable pituitary mass without signs of growth. Conclusion: We report the successful long-term treatment of TSH-omas with different therapies.

Long-term safety of azathioprine for treatment of neuromyelitis optica spectrum disorders

2021 ◽  
Vol 79 (3) ◽  
pp. 229-232
Author(s):  
Ana Beatriz Ayroza Galvão Ribeiro GOMES ◽  
Milena Sales PITOMBEIRA ◽  
Douglas Kazutoshi SATO ◽  
Dagoberto CALLEGARO ◽  
Samira Luisa APÓSTOLOS-PEREIRA
Keyword(s):  
Neuromyelitis Optica ◽  
Sao Paulo ◽  
Term Treatment ◽  
São Paulo ◽  
Duration Of Treatment ◽  
International Consensus ◽  
First Line Therapy ◽  
Long Term Treatment ◽  
Record Review

ABSTRACT Background: Azathioprine is a common first-line therapy for neuromyelitis optica spectrum disorder (NMOSD). Objective: The aim of this study was to determine whether long-term treatment (>10 years) with azathioprine is safe in NMOSD. Methods: We conducted a retrospective medical record review of all patients at the School of Medicine of the University of São Paulo (São Paulo, Brazil) who fulfilled the 2015 international consensus diagnostic criteria for NMOSD and were treated with azathioprine for at least 10 years. Results: Out of 375 patients assessed for eligibility, 19 were included in this analysis. These patients’ median age was 44 years (range=28-61); they were mostly female (17/19) and AQP4-IgG seropositive (18/19). The median disease duration was 15 years (range=10-39) and most patients presented a relapsing clinical course (84.2%). The median duration of treatment was 11.9 years (range=10.0-23.8). The median annualized relapse rates (ARR) pre- and post-treatment with azathioprine were 1 (range=0.1-2) and 0.1 (range=0-0.35); p=0.09. Three patients (15.7%) had records of adverse events during the follow-up, which consisted of chronic B12 vitamin deficiency, pulmonary tuberculosis and breast cancer. Conclusion: Azathioprine may be considered a safe agent for long-term treatment (>10 years) of NMOSD, but continuous vigilance for infections and malignancies is required.

Long-term treatment of acromegaly with the slow-release somatostatin analogue lanreotide

1994 ◽  
Vol 131 (1) ◽  
pp. 20-26 ◽  
Author(s):  
Josef Marek ◽  
Václav Hána ◽  
Michal Kršek ◽  
Vlasta Justová ◽  
France Catus ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Slow Release ◽  
Serum Levels ◽  
Term Treatment ◽  
Somatostatin Analogue ◽  
Tumour Mass ◽  
Long Term Treatment ◽  
Active Acromegaly ◽  
One Year

Marek J, Hána V. Kršek M. Justová V, Catus F, Thomas F. Long-term treatment of acromegaly with the slow-release somatostatin analogue lanreotide. Eur J Endocrinol 1994;131:20–6. ISSN 0804–4643 Thirteen patients with active acromegaly despite previous surgery were treated with 30 mg lanreotide im twice a month for 9 months. In 10 subjects the treatment continued to 19 months. GH serum levels of all patients decreased significantly from an initial value of 32.0 (29.4) μg/l [median (standard error of median)] to 10.0 (3.6) and 19.1 (5.7) after 3 and 9 months of treatment, respectively. In the 10 patients with the treatment longer than one year the decrease in GH was from 46.8 (29.4) μg/l to 12.5 (5.0) and 16.1 (5.3) after 13 and 19 months, respectively. IGF-I serum levels decreased significantly from 1193 (73)μg/l to 782 (99) and 621 (103) after 3 and 9 months, respectively, and were normalized in 3 patients. In the 10 patients treated for longer than one year, levels decreased significantly from 1318 (74)μg/l to 653 (170) and 742 (180) after 13 and 19 months, respectively. IGF BP-3 levels were reduced to the normal range in 6 patients and decreased from 8.7 (1.5)mg/l to 6.4 (0.8) and to 5.4 (1.0) after 3 and 9 months, respectively. In the patients with the 19 months treatment the decrease was from 9.3 (1.6) mg/l to 3.9 (0.9) and 4.8 (0.9) after 13 and 19 months, respectively. The IGF BP-3 to IFG I ratio increased in 7 patients. This elevation significantly correlated with the decrease in bioassayable somatomedin. Prolactin serum levels fell in all patients with increased prolactin secretion. Testosterone plasma levels increased in 4 out of 5 men without replacement therapy. Clinical improvement was observed in all patients. A reduction of tumour mass was observed in five patients and complete disappearance of the tumour in one subject. All patients complained of mild abdominal pain and softened stools for several days following the injections. However, these side effects never required interruption of treatment. Asymptomatic microlithiasis was seen in only one patient after 13 months, which led to treatment being suspended for a period of 3 months after which it was resumed. Fasting serum insulin and insulin area under the curve (AUC) after oral glucose tolerance test (OGTT) fell in all patients. Fasting blood glucose, fructosamine and glucose AUC after OGTT slightly increased during the treatment, but all blood glucose levels (fasting and during OGTT) remained within normal ranges. Lanreotide appears to be a safe and effective treatment in patients with active acromegaly unresolved by surgery. The long-acting formulation avoids the drawbacks associated with either repeated daily injections or continuous infusions of somatostatin analogues. Josef Marek, Third Department of Medicine, Charles University, U nemocnice 1, 128 21 Praha 2, The Czech Republic

Long-Term Treatment of a Metastasizing GRFoma with a Somatostatin Analogue (SMS 201-995) in a Girl with Gigantism

1986 ◽  
Vol 21 (sup119) ◽  
pp. 238-242 ◽  
Author(s):  
K. Von Werder ◽  
M. Losa ◽  
G. K. Stalla ◽  
O. A. Müller ◽  
B. Mayr ◽  
...  
Keyword(s):  
Term Treatment ◽  
Somatostatin Analogue ◽  
Long Term Treatment

A review of the efficacy and tolerability of venlafaxine

1997 ◽  
Vol 12 (S4) ◽  
pp. 307s-313s ◽  
Author(s):  
M Dierick
Keyword(s):  
Major Depression ◽  
Selective Serotonin Reuptake Inhibitors ◽  
Antidepressant Activity ◽  
Term Treatment ◽  
Selective Serotonin ◽  
First Line Therapy ◽  
Long Term Treatment ◽  
Norepinephrine Reuptake Inhibitor ◽  
Short And Long Term

SummaryVenlafaxine is a selective serotonin norepinephrine reuptake inhibitor with no activity at muscarinic, histaminergic or adrenergic receptors. The antidepressant activity of venlafaxine has been demonstrated in placebo-controlled and active comparator-controlled clinical trials. Venlafaxine was effective in outpatients and hospitalized patients with major depression and in those with melancholia, agitated or retarded symptoms, and refractory or treatment-resistant depression. Venlafaxine was at least as effective as comparative antidepressants and was more effective than fluoxetine or imipramine in some trials. A positive dose-response relationship has been shown with venlafaxine. When doses of venlafaxine are titrated rapidly upward, an onset of antidepressant action has been detected within one week in some studies. Venlafaxine is well tolerated during short- and long-term treatment. The most common adverse effects are nausea, somnolence and dry mouth. The overall tolerability of venlafaxine appears to exceed that of tricyclic antidepressants and compares favorably with that of selective serotonin reuptake inhibitors. Venlafaxine is a novel antidepressant that is appropriate for first-line therapy in patients with major depression.

Long-Term Treatment of Patients with Endocrine Gastrointestinal Tumours with the Somatostatin Analogue SMS 201-995

1986 ◽  
Vol 21 (sup119) ◽  
pp. 230-237 ◽  
Author(s):  
F. Stöckmann ◽  
G. Richter ◽  
B. Lembcke ◽  
J. M. Conlon ◽  
W. Creutzfeldt
Keyword(s):  
Term Treatment ◽  
Somatostatin Analogue ◽  
Long Term Treatment ◽  
Gastrointestinal Tumours

scholarly journals LONG TERM TREATMENT BY A LONG ACTING SOMATOSTATIN ANALOGUE (SMS 201–995) IN A 4 MONTHS BOY PRESENTING WITH PRIMARY PERMANENT HYPERINSULINISM

1988 ◽  
Vol 23 (1) ◽  
pp. 135-135 ◽  
Author(s):  
M T Tauber ◽  
J P Tauber ◽  
A G Harris ◽  
J M Lafitte ◽  
M Keddari ◽  
...  
Keyword(s):  
Term Treatment ◽  
Somatostatin Analogue ◽  
Long Term Treatment ◽  
Long Acting
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