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首页> 外文期刊>Open Journal of Internal Medicine >Abducens nerve palsy during pegvisomant therapy in an acromegalic patient
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Abducens nerve palsy during pegvisomant therapy in an acromegalic patient

机译：在肢端肥大症患者的培维索敏治疗期间诱发神经麻痹

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Pegvisomant is a recent treatment modality of acromegaly, which is most effective in regulating IGF-1 levels. Tumor growth has been reported in 5% of the acromegaly cases treated with pegvisomant. Herein we report a case of acromegaly resistant to surgical treatment, radiotherapy and medical therapy with a somatostatin analogue and cabergolin. Due to presence of pituitary tumor with cavernous sinus invasion and unremitting disease activity pegvisomant therapy was initiated. She developed left abducens nerve palsy after pegvisomant treatment. The objective of this report is to emphasize the value of close follow-up of the acromely cases under pegvisomant therapy, especially if they have cavernous sinus infiltrating tumor. A 44-year-old woman with acromegaly presented with visual defect and diplopia on left lateral gaze. Her complaint developed 3 years after initiation of pegvisomant therapy. Her neurologic examination was consistent with mild abducens nerve palsy on left side. Other causes for abducens nerve palsy were excluded. Pegvisomant was discontinued upon patient request. Although sella MRI did not reveal a tumor growth, even minimal growth within cavernous sinus can cause cranial nerve involvement. Therefore close and careful follow-up of cavernous sinus infiltrating tumors after pegvisomant therapy is crucial to early recognition of complications.
机译：培维索孟特是一种肢端肥大症的最新治疗方法，对调节IGF-1水平最有效。据报道，在接受培维索孟治疗的肢端肥大症病例中，有5％的患者出现了肿瘤生长。在本文中，我们报道了一种使用生长抑素类似物和降钙素对外科治疗，放疗和药物治疗耐药的肢端肥大症。由于存在垂体瘤并伴有海绵窦浸润和持续的疾病活动，因此开始了pegvisomant治疗。接受培维索孟治疗后，她出现了左外展神经麻痹。本报告的目的是强调对接受培维索姆治疗的肢端重症患者进行密切随访的价值，特别是如果患者患有海绵窦浸润性肿瘤。一名44岁的肢端肥大症患者左侧视线出现视觉缺陷和复视。在开始接受培维索敏治疗后3年，她的病情发展了。她的神经系统检查与左侧轻度外展神经麻痹一致。导致外展神经麻痹的其他原因被排除。应患者要求停用培维索孟。尽管蝶鞍MRI并未显示出肿瘤的生长，但即使是海绵窦内的最小生长也会引起颅神经受累。因此，在pevvisomant治疗后密切仔细地随访海绵窦浸润性肿瘤对于早期识别并发症至关重要。

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