alexa Acromegaly: A Case Study | OMICS International
ISSN: 2155-6156
Journal of Diabetes & Metabolism

Like us on:

Make the best use of Scientific Research and information from our 700+ peer reviewed, Open Access Journals that operates with the help of 50,000+ Editorial Board Members and esteemed reviewers and 1000+ Scientific associations in Medical, Clinical, Pharmaceutical, Engineering, Technology and Management Fields.
Meet Inspiring Speakers and Experts at our 3000+ Global Conferenceseries Events with over 600+ Conferences, 1200+ Symposiums and 1200+ Workshops on
Medical, Pharma, Engineering, Science, Technology and Business

Acromegaly: A Case Study

Faraz Farishta1* and Mohammed Salman Hadi2

1Consultant Endocrinologist, Maxcure Mediciti Hospital, Hyderabad, India

2Consultant Physician, Maxcure Mediciti Hospital, Hyderabad, India

*Corresponding Author:
Dr. Faraz Farishta
Consultant Endocrinologist
Maxcure Medicti Hospital
Hyderabad, India
Tel: 91 9885035977
E-mail: [email protected]

Received: September 21, 2015; Accepted: October 27, 2015; Published: October 31, 2015

Citation: Farishta F, Hadi MS (2015) Acromegaly: A Case Study. J Diabetes Metab 6:621. doi:10.4172/2155-6156.1000621

Copyright: © 2015 Farishta F, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

Visit for more related articles at Journal of Diabetes & Metabolism

Abstract

A 35 year old BHEL field worker presented with increased shoe size and tightness of ring, change in facial appearance, voice change, tingling and numbness in hands and snoring since 6 months. On examination his BP was 160/100, elongated head, prominent supra orbital ridges, Enlarged nose, lips, ear, widely spaced teeth, husky voice. Nape of neck was hyper pigmented. His systemic examination (including visual perimetry) was unremarkable. His Lab investigations were GH: 29.8 (0-3NG/ML), IGF: 811 (115-307 ng/mL). T3/T4/TSH/HBA1C/FBS/PLBS/Cortisol/ Prolactin-were within normal limits. USG Abdomen and Pelvis: Non obstructive left renal calculi (7 mm), borderline prostatomegaly, 2D-Echo-EF-60%, minimal septal hypertrophy. MRI brain showed pituitary adenoma. Treatment options for acromegaly were discussed with the patient. Patient was started on somatostatin analogue and referred to neurosurgery team for further management.

Keywords

Prostatomegaly; Acromegaly; Somatostatin analogue; Endocrine disorders

Discussion

A 35 year old field worker (BHEL) married and having 3 children, presented with symptoms of increased shoe size from 8-10 Inches and tightness of ring of ringfinger, facial changes, change of voice, numbness and tingling sensation in hands, snoring since 6 months. No history of OSA/excessive sweating/joint pains/muscle pains/ erectile dysfunction (Figure 1). No significant past or family history of endocrine disorders. On examination of elongated head, prominent supraorbital ridges, enlarged nose, lips, ear, separated teeth, husky voice, nape of neck-hyper pigmented. Temp: 37°C, BP-160/100, pulse 80/min regular [1]. Height 66 inches, foot 10 inches, hands 7.5 inches (Figure 2A-2H). Systemic examination (including visual perimetry) no abnormality detected.

diabetes-metabolism-Patient-examination

Figure 1: Patient examination before one month.

diabetes-metabolism-examination-1-month

Figure 2: Patient examination after 1 month.

Lab Investigations

GH: 29.8 (0-3 ng/mL)

Elevated IGF-1: 811 (115-307 ng/mL)

T3/T4/TSH/HBA1C/FBS/PLBS/Cortisol/Prolactin were within normal limits.

X-ray was taken for hands, ankle and skull (Figures 3-5).

diabetes-metabolism-X-ray-hands

Figure 3: X-ray of hands.

diabetes-metabolism-X-ray-ankles

Figure 4: X-ray of ankles.

diabetes-metabolism-X-ray-skull

Figure 5: X-ray of skull.

USG abdomen and pelvis: on obstructive left renal calculus (7 mm), borderline prostatomegaly 2D-ECHO- EF-60%, Minimal septal hypertrophy (Figure 6). Patient was started on Somatostatin analogue and referred to neurosurgery team for further surgical management.

diabetes-metabolism-MRI-brain

Figure 6: MRI of brain.

Acromegaly Review

This is due to GH from pituitary tumour or hyperplasia e.g. via GHRH from carcinoid tumor. It usually occurs after fusion of epiphysis [2].

Clinical features are acroparesthesia, amenorrhea, libido, headache, increased swelling, snoring, arthalgias, and backache.

Patients may have prominent supraorbital and nuchal ridges, exaggerated wrinkles with thickened facial features. They may be hirsuite with greasy skin [3].

A diagnosis is by basal serum GH ± 1GF-1 and OGTT with GH measure merd MRI pituitary fossa, visual fields, ECG, 2Decho may be needed.

Transphenoidal surgery is first line of treatment. Drugs (e.g. somatostatin analogues, GH antagonists), Radiotherapy are alternatives.

References

Select your language of interest to view the total content in your interested language
Post your comment

Share This Article

Relevant Topics

Recommended Conferences

  • Annual Congress on Research and Innovations in Medicine July 02-03, 2018 Bangkok, Thailand
    July 02-03, 2018 Bangkok, Thailand
  • International Conference on Medical and Health Science August 24-25, 2018 Tokyo, JAPAN
    August 24-25, 2018 Tokyo, Japan

Article Usage

  • Total views: 8443
  • [From(publication date):
    November-2015 - Jun 21, 2018]
  • Breakdown by view type
  • HTML page views : 8337
  • PDF downloads : 106
 

Post your comment

captcha   Reload  Can't read the image? click here to refresh

Peer Reviewed Journals
 
Make the best use of Scientific Research and information from our 700 + peer reviewed, Open Access Journals
International Conferences 2018-19
 
Meet Inspiring Speakers and Experts at our 3000+ Global Annual Meetings

Contact Us

Agri & Aquaculture Journals

Dr. Krish

[email protected]

+1-702-714-7001Extn: 9040

Biochemistry Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Business & Management Journals

Ronald

[email protected]

1-702-714-7001Extn: 9042

Chemistry Journals

Gabriel Shaw

[email protected]

1-702-714-7001Extn: 9040

Clinical Journals

Datta A

[email protected]

1-702-714-7001Extn: 9037

Engineering Journals

James Franklin

[email protected]

1-702-714-7001Extn: 9042

Food & Nutrition Journals

Katie Wilson

[email protected]

1-702-714-7001Extn: 9042

General Science

Andrea Jason

[email protected]

1-702-714-7001Extn: 9043

Genetics & Molecular Biology Journals

Anna Melissa

[email protected]

1-702-714-7001Extn: 9006

Immunology & Microbiology Journals

David Gorantl

[email protected]

1-702-714-7001Extn: 9014

Materials Science Journals

Rachle Green

[email protected]

1-702-714-7001Extn: 9039

Nursing & Health Care Journals

Stephanie Skinner

[email protected]

1-702-714-7001Extn: 9039

Medical Journals

Nimmi Anna

[email protected]

1-702-714-7001Extn: 9038

Neuroscience & Psychology Journals

Nathan T

[email protected]

1-702-714-7001Extn: 9041

Pharmaceutical Sciences Journals

Ann Jose

[email protected]

1-702-714-7001Extn: 9007

Social & Political Science Journals

Steve Harry

[email protected]

1-702-714-7001Extn: 9042

 
© 2008- 2018 OMICS International - Open Access Publisher. Best viewed in Mozilla Firefox | Google Chrome | Above IE 7.0 version
Leave Your Message 24x7