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Pegvisomant-Induced Lipohypertrophy: Report of a Case with Histopathology
- Monica Marazuela, MD, PhD;
- Esteban Daudén, MD, PhD;
- Elena Ocón, MD;
- Dolores Moure, MD; and
- Lia Nattero, MD
- From Hospital de la Princesa, Universidad Autónoma, Madrid 28006, Spain.
Background: In a recent report, Maffei and colleagues (1) described 2 patients who developed subcutaneous lipohypertrophy in the abdomen during pegvisomant therapy (Somavert, Pfizer, New York).
Objective: To describe the effect of pegvisomant-induced lipohypertrophy on insulin-like growth factor I (IGF-I) levels.
Case Report: A 50-year-old woman with active acromegaly was prescribed subcutaneous pegvisomant, 10 mg/d, after a lack of response to somatostatin analogues. After 2 months of therapy, IGF-I levels reached the low normal range (Figure 1). After 4 months of therapy, IGF-I returned to pretreatment levels. The IGF-I levels did not reach the normal range despite the pegvisomant dose being increased (Figure 1). At month 8, a thorough clinical examination revealed a soft, painless swelling at the left arm at the injection site (Figure 2, left). The mass was soft, rounded, movable, and skin-colored; the size was …
