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. 2023 Jun 14;14:1166076. doi: 10.3389/fendo.2023.1166076

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Copyright © 2023 Trivellin, Daly, Hernández-Ramírez, Araldi, Tatsi, Dale, Fridell, Mittal, Faucz, Iben, Li, Vitali, Stojilkovic, Kamenicky, Villa, Baussart, Chittiboina, Toro, Gahl, Eugster, Naves, Jaffrain-Rea, de Herder, Neggers, Petrossians, Beckers, Lania, Mains, Eipper and Stratakis

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Clinical findings in the index family with pituitary gigantism. (A) Pedigree. Generation numbers are represented by Roman numerals, and individual numbers are in Arabic numerals. The proband is II-2, indicated by the black arrow. Open square/circle, unaffected male/female; filled square, affected male. The peptidylglycine α-amidating monooxygenase (PAM) mutational status is shown under each screened individual. In (B), the white arrowheads point to a possible 4 mm lesion (left panel, sagittal plane; right panel, coronal plane) seen in II-2. (C) Growth chart for individual III-3 before and after medical interventions. (D) A sagittal T2-weighted magnetic resonance imaging of individual III-3 that was performed before medical therapy began did not reveal a pituitary lesion. (E) Time course of the effects of treatment modalities on the growth hormone (GH; left axis) and IGF-1 (right axis; squares) in individual III-3. The rapid decrease of IGF-1 after switching from lanreotide (LAN) to pegvisomant (PegV) is evident.