endofocusFOCUS ЭндокринологияFOCUS. Endocrinology2713-01772713-0185ООО "Издательство "Перо"10.15829/2713-0177-2023-4-30endofocus-52Research ArticleСтатьиОсобенности течения соматолактотропных опухолей гипофиза. Описание клинического случаяFeatures of the course of somatolactotrophic tumors of the pituitary gland. Description of clinical casehttps://orcid.org/0000-0001-7405-486XМоруговаТ. В.MorugovaT. V.

д.м.н., профессор, зав. кафедрой эндокринологии

450008, г. Уфа, ул. Ленина, д. 3

Dr. Sc. (Med.), professor, head Department of Endocrinology

450008, Ufa, st. Lenina, 3

tmorugova@yandex.ruhttps://orcid.org/0000-0002-1590-6433АвзалетдиноваД. Ш.AvzaletdinovaD. S.

к.м.н., доцент, доцент кафедры эндокринологии

450008, г. Уфа, ул. Ленина, д. 3

C. Sc. (Med.), associate professor of the department of endocrinology

450008, Ufa, st. Lenina, 3

hyppocrat@mail.ruhttps://orcid.org/0000-0003-2532-2885МоруговаИ. В.MorugovaI. V.

к.м.н., доцент кафедры эндокринологии

450008, г. Уфа, ул. Ленина, д. 3

 

 

associate professor of the department of endocrinology

450008, Ufa, st. Lenina, 3

irinamorugova@yandex.ruФедеральное государственное бюджетное образовательное учреждение высшего образования «Башкирский государственный медицинский университет» Министерства здравоохранения Российской ФедерацииBashkir State Medical UniversityФедеральное государственное бюджетное образовательное учреждение высшего образования «Башкирский государственный медицинский университет» Министерства здравоохранения Российской Федерации ; Медико-санитарная часть ООО «Газпром трансгаз Уфа»Bashkir State Medical University ; Medico-sanitary part of Gazprom Transgaz Ufa LLC20231812202344Нейроэндокринология7581Copyright © Моругова Т.В., Авзалетдинова Д.Ш., Моругова И.В., 20242024Моругова Т.В., Авзалетдинова Д.Ш., Моругова И.В.Morugova T.V., Avzaletdinova D.S., Morugova I.V.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://endofocus.elpub.ru/jour/article/view/52

Пациентке 32 лет с первичным бесплодием, без галактореи и  нарушений менструального цикла, на основании гиперпролактинемии, наличия образования гипофиза по данным магнитно-резонансной томографии был выставлен диагноз пролактинсекретирующей микроаденомы гипофиза. На фоне лечения каберголином наступила беременность, закончилась рождением доношенного здорового ребенка. После родов пациентка возобновила прием 0,5 мг каберголина 1 раз в 2 недели, наблюдалось выраженное снижение уровня пролактина, но рост аденомы гипофиза прогрессировал до макроаденомы. Акромегалоидных черт не наблюдалось.

На фоне отмены каберголина выявлено повышение уровня гормона роста и инсулиноподобного фактора роста 1. Оральный глюкозотолерантный тест с 75 грамм глюкозы подтвердил соматотропинпродуцирующую активность макроаденомы гипофиза. В возрасте 43 лет пациентке выполнена транссфеноидальная аденомэктомия, в течение последних 6 лет наблюдается ремиссия.

Цель настоящей работы - акцентировать внимание практикующих врачей на выявлении возможной смешанной гормональной активности микроаденом гипофиза.

A patient aged 32 with complaints of primary infertility based on additional examination data (increased blood prolactin level, presence of pituitary gland formation according to magnetic resonance imaging of the brain) was diagnosed with prolactin-secreting pituitary microadenoma. At the same time, galactorrhea and menstrual disorders were not noted. Against the background of cabergoline treatment, a pregnancy occurred, which ended with the birth of a full-term healthy child. After delivery, the patient resumed dosing cabergoline 0.5 mg 1 once every two weeks, against the background of which a pronounced decrease in prolactin levels was observed, but there was a progression in the growth of pituitary adenoma (macroadenoma). No acromegaly traits were observed in the patient.

Against the background of withdrawal of cabergoline, the patient underwent a study of tropical pituitary hormones, which revealed an increase in the level of growth hormone and insulin-like growth factor-1. During the oral glucose tolerance test with 75 grams of glucose, the somatotropin-producing activity of the pituitary macroadenoma was confirmed. At the age of 43, the patient underwent transsphenoidal adenomectomy, after which she experienced persistent remission for past 6 years.

The purpose of this work is to focus the attention of practitioners on the manifestation of possible mixed hormonal activity of pituitary microadenomas.

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