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Concurrent diagnosis of acromegaly and diabetic ketoacidosis
1Department of Medicine, Maricopa Medical Center, 2601 East Roosevelt Street, Phoenix AZ 85008, USA.
Objective:
To report the occurrence of diabetic ketoacidosis (DKA) in a patient with acromegaly.
Methods:
A case report with clinical and laboratory details is presented, and the few other cases of DKA and acromegaly from the literature are discussed.
Results:
A 37-year-old man requested a consultation because of nausea, vomiting, polydipsia, polyuria, and weight loss. Physical examination revealed findings suggestive of acromegaly, including coarse facial features and enlargement of his hands and feet. Laboratory studies confirmed the diagnoses of DKA and acromegaly. Magnetic resonance imaging disclosed the presence of a pituitary adenoma, which was subsequently removed surgically. Although the DKA had been managed with insulin therapy, 2 weeks postoperatively the insulin dose was tapered and then discontinued because of hypoglycemia. Follow-up showed normalization of growth hormone levels and plasma glucose levels. Only three other cases of DKA associated with acromegaly were found in the medical literature.
Conclusion:
Although DKA is rarely diagnosed in conjunction with acromegaly, this unusual association was confirmed in the current patient.