ECE2018 Poster Presentations: Pituitary and Neuroendocrinology Growth hormone IGF axis - basic (4 abstracts)
Hirsutism as presenting clinical sign of acromegaly
Maria Pissia , Spyridon Sapounas , George Simeakis , Ioanna Patinioti , Katerina Saltiki , Vassiliki Vasileiou , Maria Alevizaki , Eleni Anastasiou & Evangelia Zapanti
Endocrinology Dept Alexandra Hospital, Athens, Greece.
Case report: Hirsutism although common in acromegaly (24%) is not considered as the prevalent symptom of the disease. Here we describe a seventy-one year old woman with a 2-year history of hyperandronism and subtle acromegalic features (macroglossia, sleep apnea). Clinical examination showed hirsutism (Ferrimann-Gallwey score 20/34), acanthosis nigricans and mild clitoridomegaly. Blood examination revealed elevated IGF-1: 502 ng/ml (69–200 ng/ml) and standard oral glucose tolerance test (OGTT) showed a diabetic curve and failed to show suppression of GH levels (post glucose GH: 1.8 ng/ml). The diagnosis of acromegaly was made accordingly. Laboratory results also revealed elevated levels of testosterone: 4.0 nmol/l (0.35–2.6) and androstenedione: 3.7 ng/ml (0.3–3.5) and normal levels of DHEAS: 2.69 μmol/l (1.77–10.5). Sella MRI was negative for pituitary adenoma. Further imaging failed to identify any cause for GH excess. Ultrasound of the ovaries did not reveal any morphologic abnormalities. The patient was treated with SST analogs with prompt response. Hormonal follow-up and imaging were normal. This case intends to emphasize that hirsutism may rarely be a prominent feature of acromegaly. The recognition of hyperandrogenism in a subset of acromegalic patients with hirsutism as a cardinal feature would facilitate early detection and diagnosis.
Volume 56
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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