Pegvisomant
- PDF / 141,511 Bytes
- 1 Pages / 623.591 x 841.847 pts Page_size
- 26 Downloads / 182 Views
1
Pegvisomant Lipoatrophy: case report During treatment with pegvisomant, a 33-year-old woman with acromegaly developed subcutaneous lipoatrophy with subsequent impairment of drug absorption and effectiveness. The woman, who had previously received radiotherapy and somatostatin, started receiving SC pegvisomant 15 mg/day in combination with octreotide. Her insulin-like growth factor 1 (IGF-1) levels subsequently normalised. About 3.5 years after pegvisomant start, the skin of both arms became irregularly excavated at the site of pegvisomant injections. On ultrasonography, she had atrophy of subcutaneous tissue fat; this resulted in tight contact between the dermis and underlying muscle. Laboratory investigations revealed her IGF-1 levels had increased to above normal levels; her growth hormone levels were slightly decreased. On ultrastructural skin analysis, the subcutaneous fat tissue was substituted by collagen fibers and fibroblasts, and infiltrated by mast cells, histiocytes and lymphocytes. There was also thickening and reduplication of the endothelial basement membrane of capillaries and venules. One month after pegvisomant injections were rotated from arms to abdomen and thighs, the woman’s IGF-1 levels had normalised. Author comment: "Subcutanenous lipoatrophy, observed for the first time in our patient, was probably due to local inflammatory reaction to [polyethylene glycol] molecules of pegvisomant, injected for long-time and in a limited extension site." Ragonese M, et al. Subcutaneous lipoatrophy induced by long-term pegvisomant administration in a patient with acromegaly. Journal of Endocrinological 801122162 Investigation 31 (Suppl.): 35, No. 4, 2008 - Italy
0114-9954/10/1216-0001/$14.95 Adis © 2010 Springer International Publishing AG. All rights reserved
Reactions 23 Aug 2008 No. 1216
Data Loading...
