Endocrine Abstracts

The association of acromegaly and end stage renal disease was not reported before. Here, we present a case of 57 years old male patient who had been followed with the diagnosis of 13 years of acromegaly and 18 years of type 2 diabetes at another center until 2005 when he was admitted to our outpatient clinic. He had been operated for a pituitary macroadenoma 13 years ago and followed without treatment for acromegaly. He was treated with long acting insulin and he was metabolically under control (HbA1c 5.7%) for diabetes. Somatostatin analogue (octreotide LAR) treatment was initiated because of high GH response to oral glucose tolerance test and IGF1 levels accepted according to age and sex. During follow-up his blood pressure elevated, trandolapril and verapamil combination was added to treatment and when he was screened for diabetes complications retinopathy and nephropathy (4.1 g/24 h proteinuria) was discovered. After diagnosis of nephropathy, his renal functions deteriorated very quickly, dialysis and renal transplantation was performed from a cadaver for end-stage renal disease in 2008. Octreotide LAR treatment was suspended for 3 months. He received immunosuppressive treatment (everolimus, mycophenolic acid, and prednisolone) and intensive insulin treatment for elevation of blood glucose levels after the transplantation. Until now he is metabolically under control for diabetes and renal functions as well as acromegaly. According to our search, this is is the first case reported in the literature and it can be concluded that in the work-up of acromegaly and diabetes clinicians should be alert for renal complications.