Uneventful octreotide LAR therapy throughout three pregnancies, with favorable delivery and anthropometric measures for each newborn: a case report

Deeb Daoud Naccache,Zila Shen-Or,Michal Armoni,Ali Yahia,George Kontogeorgos,Adnan Zaina

doi:10.1186/1752-1947-5-386

Deeb Daoud Naccache, Zila Shen-Or + Show 4 more

Open Access

https://doi.org/10.1186/1752-1947-5-386

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Abstract

IntroductionThe safety of octreotide use, in its short-acting preparation, in pregnancy is still unclear. This report provides the first documentation of uneventful octreotide LAR use during three pregnancies in a woman with bronchial carcinoid-associated adrenocorticotropic hormone-dependent Cushing's syndrome.Case presentationA 25-year-old Arabic woman presented to our emergency department with rapid onset of headache, flaring acne and hirsutism, facial puffiness, weight gain and paroxysmal myopathy, and paranoiac thoughts of rape and sexual intimidation. After undergoing surgical removal of a mass by left lower lung lobectomy, her residual lung disease medical therapy failed. Chronic octreotide LAR injections were initiated as indicated by a positive octreoscan.Follow-up revealed a long-lasting positive response to octreotide. Avidity of octreotide to somatostatin receptor sub-type 2 was later confirmed by a positive somatostatin receptor sub-type 2 in the resected tumor specimen. Against our instructions, the patient had three spontaneous pregnancies leading to delivery of three full-term healthy children while her octreotide LAR therapy continued.ConclusionThis case adds more data supporting the potential for the safe use of octreotide and the feasibility of octreotide LAR use during pregnancy, making compliance with the patient's preference not to withdraw octreotide therapy as soon as her pregnancy is confirmed a thoughtful option.

Highlights

The safety of octreotide use, in its short-acting preparation, in pregnancy is still unclear
18% of patients with positive octreoscan results do not respond to somatostatin analogues [20]
First, our report demonstrates increased evidence for the safety of octreotide treatment throughout pregnancy in addition to that described in the seven previous case reports of safe octreotide therapy, using short- or longacting preparations, during pregnancy

Summary

Conclusion

This case adds more data supporting the potential for the safe use of octreotide and the feasibility of octreotide LAR use during pregnancy, making compliance with the patient’s preference not to withdraw octreotide therapy as soon as her pregnancy is confirmed a thoughtful option

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11. Neal JM