Maternal–Fetal Transfer of Octreotide

Abstract

Octreotide, a long-acting analogue of somatostatin, is effective therapy for patients with thyrotropin (TSH)-secreting pituitary adenomas.¹ A 31-year-old infertile woman with hyperthyroidism caused by a TSH-secreting macroadenoma was treated with a continuous subcutaneous infusion of 300 μg of octreotide per day. She became euthyroid, and the macroadenoma decreased in size, as determined by magnetic resonance imaging (MRI). Subsequently, the woman was found to be pregnant, and therefore octreotide treatment was stopped at one month of gestation.^2,3 At six months of gestation she was again hyperthyroid, her serum TSH concentration was elevated, visual-field examination was abnormal, and MRI showed enlargement of the macroadenoma. After the patient gave informed consent, continuous octreotide therapy (300 μg per day) was resumed. Her serum TSH and thyroid hormone concentrations fell to normal, her visual fields improved, and the macroadenoma decreased in size.