Endocrine Abstracts

Background: Acromegaly is a rare Endocrine condition caused by excessive secretion of growth hormone; in 2022, there were approximately 3500 people with a known diagnosis in the UK. Patients with Acromegaly can achieve successful remission of the disease with medical therapy, pituitary surgery and radiotherapy (sometimes a single treatment, sometimes combination). However, these treatment options have associated risks, including side effects, late effects of radiotherapy and poor surgical outcomes. To further complicate matters, Acromegaly can be resistant to these treatment options, increasing the risk of increased morbidity and mortality.

Case Study Subject: We present a case of Acromegaly in a 24 year old female, during her first pregnancy. She initially presented in A&E (Derby) with severe headaches in December 2019, along with disturbed vision in her right eye and partial ptosis; interestingly she had also noticed an increase in her shoe size over several months, which prompted investigation and led to a diagnosis of Acromegaly. This complex case was managed during the highly challenging time of Covid19, through a collaborative approach of multiregional centres (Derby, Nottingham, Sheffield, Oxford), whilst the majority of care was provided by her local hospitals (Derby and Nottingham). We will review the evidence for best practice and the processes used to achieve reduction of growth hormone and IGF1 levels, remission of Acromegaly and reduced risk factors to mother and child (resulting in a successful birth and improved prognosis).