Severe Allergic Reaction Caused by Pre-Operative Somatostatin Analog Treatment of Tsh- and Gh- Secreting Pituitary Adenoma: A Case Report | Biomedgrid

TSH-and GH-secreting pituitary adenomas are rare and account for fewer than 1% [1, 2]. Nowadays, neurosurgery is still considered to be the first-line therapy for this kind of tumor [3]. In the meanwhile, pre-operative medical therapy with somatostatin analogues (SSA) is increasingly used and considered highly effective in reducing thyroid-stimulating hormone (TSH) and growth hormone (GH) secretion [4]. This report described a rare case of a TSH/GH co-secreting pituitary adenoma, which was initially noted as atrial fibrillation and heart failure. During the period of pre-operative therapy with SSA, the patient was affected by rare side effects, hyperthermia and pancytopenia, which was deemed to be a kind of allergic reaction. Then the patient took a transsphenoidal resection of the tumor. After the surgery, he was treated with radiotherapy, followed by methimazole and dopamine agonists. Finally, his thyroid function fell back to normal, as well as his GH, insulin-like growth factor 1 (IGF-1) and complete blood count (CBC). In summary, this patient had a rare and severe adverse reaction with the treatment of SSA and a serious risk of undergoing surgery due to the cardiac complications. Fortunately, the patient's disease was finally well controlled through rigorous preoperative preparation, successful neurosurgery and postoperative radiotherapy followed by medical therapy, which should be attributed to the multidisciplinary collaboration.