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Acromegaly and diabetes mellitus associated with hyperthyroidism.
Neuro Endocrinology Letters
|July 1, 2014
Summary
This case study highlights a rare presentation of acromegaly, where thyrotoxicosis was the initial symptom. Treatment improved the patient
Area of Science:
- Endocrinology
- Oncology
- Internal Medicine
Background:
- Acromegaly, a disorder caused by excess growth hormone (GH), often presents with various metabolic and endocrine disturbances.
- Primary hyperthyroidism and diabetes mellitus are common comorbidities, but thyrotoxicosis as the initial presenting illness in acromegaly is particularly uncommon.
Observation:
- A 66-year-old woman presented with symptoms suggestive of acromegaly and primary hyperthyroidism. Investigations revealed inappropriately high serum GH levels, an intrasellar mass on MRI, and elevated thyroid hormones with suppressed TSH.
- The patient had poorly controlled diabetes mellitus (HbA1c 12.2%) and a multinodular goiter on ultrasound. Pituitary lesion histology confirmed a GH-secreting eosinophilic adenoma.
Findings:
- The patient's thyrotoxicosis was the first presenting illness, a rare initial manifestation of acromegaly.
- Surgical resection of the pituitary adenoma led to clinical improvement but resulted in secondary hypoadrenalism.
Implications:
- This case underscores the importance of considering acromegaly in patients with unexplained thyrotoxicosis and diabetes mellitus.
- The development of secondary hypoadrenalism post-surgery highlights the need for careful monitoring and management of pituitary function after adenoma resection.
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