ECE2014 Poster Presentations Growth hormone IGF axis basic (16 abstracts)
Young female with acromegaloid features, pituitary macroadenoma, and an uncomplicated pregnancy
Carlos Figueroa , Monica Santiago , Jose Hernan , Michelle Mangual , Madeleine Gutierrez , Coromoto Palermo , Rafael Trinidad , Alfredo Sanchez & Maria DeLourdes Miranda
San Juan City Hospital, San Juan, Puerto Rico.
Thirty-two years old female G2P1A0 seen at our endocrinology clinic 9 years ago complaining of persistent menstrual irregularities associated to elevated prolactin values. MRI done revealed a pituitary microadenoma. However, she refused treatment for microprolactinoma. Four years afterwards, patient return complaining of recurrent episodes of headache. Repeated MRI showed a pituitary macroadenoma, so start on cabergoline treatment.
Once more, patient was lost to follow-up and on 2012 she visited our clinic at 24th weeks of gestation with history of progressive hands and feet enlargement. On physical examination marked prognathism, hands and feet enlargement, acanthosis nigricans and hirsutism were found, so acromegaly was suspected. Elevations of prolactin and IGF1 levels were found during whole pregnancy.
After 6 months post-partum, laboratories were repeated and basal and 2 h insulin showed marked elevation, increased HOMA index, and normal IGF1 and GH values. Thus, the diagnosis of insulin mediated pseudoacromegaly was confirmed.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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