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Acromegaly Initially Presenting with Severe Infectious Diseases: A Case Report
Eriko Tani1, Tomonori Hirashima2, Takamasa Hasegawa3
1Department of Respiratory Medicine, Ishikiri-Seiki Hospital, Higashi-Osaka, Japan.
JMA Journal
|February 28, 2022
Summary
A critical illness case revealed undiagnosed acromegaly, a rare growth hormone disorder. Early recognition of acromegaly
Area of Science:
- Endocrinology
- Internal Medicine
- Radiology
Background:
- Acromegaly is a rare endocrine disorder caused by excess growth hormone (GH).
- It often presents insidiously with subtle physical changes.
- Delayed diagnosis can lead to significant morbidity.
Observation:
- A 39-year-old male with sepsis and multiple abscesses exhibited physical features suggestive of acromegaly.
- Enlarged features including toe tips, eyebrows, nose, lips, and feet were noted.
- These subtle signs were overlooked until a pulse oximeter measurement was difficult.
Findings:
- Magnetic resonance imaging (MRI) revealed a pituitary mass.
- Computed tomography (CT) showed characteristic bone changes like thickened heel pads and enlarged sinuses.
- An oral glucose tolerance test confirmed paradoxical GH elevation, diagnosing acromegaly.
Implications:
- This case highlights the importance of recognizing acromegaly in patients with severe infections.
- Physicians should consider acromegaly in their differential diagnosis when physical signs are apparent.
- Timely diagnosis and treatment of acromegaly can improve patient outcomes.
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