Hippokratia. 2012; 16 (1): 80-82

C. Dimopoulou, C. Sievers, M. Bidlingmaier, GK. Stalla

Abstract

Background: The competitive GH receptor antagonist pegvisomant is reported to normalise IGF-1 levels in up to 97 % of acromegalic patients at a maximum dosage of 40 mg/d.
Description of Case: We present an acromegalic patient resistant to the recommended maximum GH receptor antagonist dosage. The 60-year-old male patient presenting with typical clinical signs of acromegaly has underwent multiple transsphenoidal surgeries and pituitary irradiation, while currently available pharmacological therapies for acromegaly have been exhausted.
Results: Biochemical control of the disease could only be achieved until uptitration of pegvisomant to 60 mg/d which was tolerated well.
Conclusions: The current treatment algorithm for acromegaly should be modified to treat cases of persistent and uncontrolled disease.

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