Missed diagnosis and delayed treatment of acromegaly in a patient with severe diabetes: A case report

  • Authors:
    • Kota Nishihama
    • Yutaka Yano
    • Taro Yasuma
    • Esteban C. Gabazza
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  • Published online on: October 27, 2020     https://doi.org/10.3892/etm.2020.9394
  • Article Number: 264
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Abstract

The early stages of acromegaly are characterized by slow and progressive acral overgrowth without major systemic complications. Failure to diagnose acromegaly at an early stage may have devastating consequences on patient care. The case in the present report was a 44‑year‑old Japanese man, referred to Kuwana City Medical Center due to severe hyperglycemia detected in a general checkup. The patient had no acromegaly‑related complaints. Laboratory data revealed high blood levels of hemoglobin A1c and glucose. Careful physical examination revealed enlargement of extremities and soft tissues. Laboratory investigation indicated a high blood concentration of growth hormone, and magnetic resonance imaging disclosed an enhanced pituitary tumor. The diagnosis was pituitary tumor‑associated acromegaly with severe diabetic complications. The pituitary tumor became large and unresectable following 10 years of misdiagnosis. The patient was treated with somatostatin receptor ligands (lanreotide and pasireotide), as well as bromocriptine in Mie University Hospital. The tumor size was reduced following treatment, though it was still unresectable at the time of this report. The case highlights the importance of hyperglycemia and abnormal manifestations of the feet in patients with acromegaly. In addition, these findings highlight the need for a thorough examination of the feet in diabetic patients, and the critical importance of the early diagnosis of acromegaly for preventing the consequences of inappropriate patient care.
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December-2020
Volume 20 Issue 6

Print ISSN: 1792-0981
Online ISSN:1792-1015

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Spandidos Publications style
Nishihama K, Yano Y, Yasuma T and Gabazza EC: Missed diagnosis and delayed treatment of acromegaly in a patient with severe diabetes: A case report. Exp Ther Med 20: 264, 2020
APA
Nishihama, K., Yano, Y., Yasuma, T., & Gabazza, E.C. (2020). Missed diagnosis and delayed treatment of acromegaly in a patient with severe diabetes: A case report. Experimental and Therapeutic Medicine, 20, 264. https://doi.org/10.3892/etm.2020.9394
MLA
Nishihama, K., Yano, Y., Yasuma, T., Gabazza, E. C."Missed diagnosis and delayed treatment of acromegaly in a patient with severe diabetes: A case report". Experimental and Therapeutic Medicine 20.6 (2020): 264.
Chicago
Nishihama, K., Yano, Y., Yasuma, T., Gabazza, E. C."Missed diagnosis and delayed treatment of acromegaly in a patient with severe diabetes: A case report". Experimental and Therapeutic Medicine 20, no. 6 (2020): 264. https://doi.org/10.3892/etm.2020.9394