Endocrine Abstracts

Aims: To present the case of a 69-year-old female patient who was diagnosed with acromegaly two years following the initial onset of facial and acral symptoms, having already developed colonic hyperplastic polyps, one of the complications associated with acromegaly, one year prior to diagnosis.

Material: Case report and literature review.

Method: Acromegaly was diagnosed based on clinical suspicion, raised IGF-1 level, absence of GH suppression following OGTT, brain MRI and histology.

Results: After recognition of phenotypical, particularly facial and acral, features of acromegaly, IGF-1 level was elevated at 624 nmol/L, OGTT failed to suppress GH nadir levels, and brain MRI showed a pituitary macroadenoma which was identified histologically as a mixed, sparsely granulated somatotroph and lactotroph adenoma.

Discussion and conclusion: The onset of acromegaly can be insidious in older patients leading to complications and delayed diagnosis. Early diagnosis of acromegaly and effective screening and monitoring for its complications decreases morbidity and mortality and improves overall prognostic outcomes and quality of life. Had the hyperplastic polyps detected on colonoscopy in our patient been recognised as a feature of acromegaly, the diagnosis may have been established earlier. Therefore, it is crucial to raise the awareness within other specialties of all the features and complications of acromegaly.