Status epilepticus and diabetes ketoacidosis: uncommon clinical presentations of acromegaly
Acromegaly is a rare disease caused by hypersecretion of the growth hormone (GH). Most cases are caused by either pituitary microadenoma or macroadenoma. The GH producing tumors present with clinical manifestations of acromegaly due to excessive GH secretion or symptoms resulting from mass effects o...
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| Format: | Article |
| Language: | English |
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Bioscientifica
2021-05-01
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| Series: | Endocrinology, Diabetes & Metabolism Case Reports |
| Online Access: | https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM20-0156.xml |
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| author | Nyasatu G Chamba Ahlam A Amour Abid M Sadiq Tecla R Lyamuya Emmanuel V Assey Adnan M Sadiq William P Howlett |
| author_facet | Nyasatu G Chamba Ahlam A Amour Abid M Sadiq Tecla R Lyamuya Emmanuel V Assey Adnan M Sadiq William P Howlett |
| author_sort | Nyasatu G Chamba |
| collection | DOAJ |
| description | Acromegaly is a rare disease caused by hypersecretion of the growth hormone (GH). Most cases are caused by either pituitary microadenoma or macroadenoma. The GH producing tumors present with clinical manifestations of acromegaly due to excessive GH secretion or symptoms resulting from mass effects of the enlarging tumor. The physical changes are usually slow and, therefore, recognition of the disease is delayed. These adenomas are never malignant but can have significant morbidity and mortality. A subgroup of patients with acromegaly present with severe hyperglycemia resulting in diabetic ketoacidosis (DKA) which requires insulin. Rarely are pituitary tumors responsible for generalized convulsions except when they are too large. We hereby present two cases, the first is that of a 26-year-old female who presented with new onset status epilepticus, DKA with a 1-year history of diabetes mellitus (DM). On examination, she had clinical features of acromegaly. The second case is that of a 34-year-old female who presented with new onset status epilepticus, hyperglycemia with a history of recently diagnosed DM, and features of gigantism. In both cases, their diagnosis was confirmed by elevated serum GH and later by elevated insulin-like growth factor type 1 levels, and CT of the head demonstrating large pituitary macroadenoma. The importance of clinical history and examination, as well as investigations is vital in the recognition of acromegaly. The prognosis of acromegalic patients depends on early clinical recognition and tumor size reduction by either medical or surgical therapy. |
| first_indexed | 2024-12-19T23:44:21Z |
| format | Article |
| id | doaj.art-83d42c360bac4fa79462409022d71528 |
| institution | Directory Open Access Journal |
| issn | 2052-0573 2052-0573 |
| language | English |
| last_indexed | 2024-12-19T23:44:21Z |
| publishDate | 2021-05-01 |
| publisher | Bioscientifica |
| record_format | Article |
| series | Endocrinology, Diabetes & Metabolism Case Reports |
| spelling | doaj.art-83d42c360bac4fa79462409022d715282022-12-21T20:01:20ZengBioscientificaEndocrinology, Diabetes & Metabolism Case Reports2052-05732052-05732021-05-01111610.1530/EDM-20-0156Status epilepticus and diabetes ketoacidosis: uncommon clinical presentations of acromegalyNyasatu G Chamba0Ahlam A Amour1Abid M Sadiq2Tecla R Lyamuya3Emmanuel V Assey4Adnan M Sadiq5William P Howlett6Department of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Moshi, TanzaniaMnazi Mmoja Hospital, Zanzibar, TanzaniaDepartment of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Moshi, TanzaniaDepartment of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, TanzaniaDepartment of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, TanzaniaKilimanjaro Christian Medical University College, Moshi, Tanzania; Department of Radiology, Kilimanjaro Christian Medical Centre, Moshi, TanzaniaDepartment of Internal Medicine, Kilimanjaro Christian Medical Centre, Moshi, Tanzania; Kilimanjaro Christian Medical University College, Moshi, TanzaniaAcromegaly is a rare disease caused by hypersecretion of the growth hormone (GH). Most cases are caused by either pituitary microadenoma or macroadenoma. The GH producing tumors present with clinical manifestations of acromegaly due to excessive GH secretion or symptoms resulting from mass effects of the enlarging tumor. The physical changes are usually slow and, therefore, recognition of the disease is delayed. These adenomas are never malignant but can have significant morbidity and mortality. A subgroup of patients with acromegaly present with severe hyperglycemia resulting in diabetic ketoacidosis (DKA) which requires insulin. Rarely are pituitary tumors responsible for generalized convulsions except when they are too large. We hereby present two cases, the first is that of a 26-year-old female who presented with new onset status epilepticus, DKA with a 1-year history of diabetes mellitus (DM). On examination, she had clinical features of acromegaly. The second case is that of a 34-year-old female who presented with new onset status epilepticus, hyperglycemia with a history of recently diagnosed DM, and features of gigantism. In both cases, their diagnosis was confirmed by elevated serum GH and later by elevated insulin-like growth factor type 1 levels, and CT of the head demonstrating large pituitary macroadenoma. The importance of clinical history and examination, as well as investigations is vital in the recognition of acromegaly. The prognosis of acromegalic patients depends on early clinical recognition and tumor size reduction by either medical or surgical therapy.https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM20-0156.xml |
| spellingShingle | Nyasatu G Chamba Ahlam A Amour Abid M Sadiq Tecla R Lyamuya Emmanuel V Assey Adnan M Sadiq William P Howlett Status epilepticus and diabetes ketoacidosis: uncommon clinical presentations of acromegaly Endocrinology, Diabetes & Metabolism Case Reports |
| title | Status epilepticus and diabetes ketoacidosis: uncommon clinical presentations of acromegaly |
| title_full | Status epilepticus and diabetes ketoacidosis: uncommon clinical presentations of acromegaly |
| title_fullStr | Status epilepticus and diabetes ketoacidosis: uncommon clinical presentations of acromegaly |
| title_full_unstemmed | Status epilepticus and diabetes ketoacidosis: uncommon clinical presentations of acromegaly |
| title_short | Status epilepticus and diabetes ketoacidosis: uncommon clinical presentations of acromegaly |
| title_sort | status epilepticus and diabetes ketoacidosis uncommon clinical presentations of acromegaly |
| url | https://edm.bioscientifica.com/view/journals/edm/2021/1/EDM20-0156.xml |
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