Objectives: To evaluate the presence of diabetes mellitus (DM) in a cohort of patients with acromegaly. Methods: This was a cross sectional study. Results: Fifty-eight acromegalic patients were assessed. Only 29% met the criteria for cure, and 27% had the disease controlled. Twenty-two had DM; HbA1c was equal to 7.34 ± 2.2%. Most of the diabetic patients (18 out of 22, 82%) did not meet criteria for cure. They were more often hypertensive [16/22 (73%)

SUMMARYBenign intracranial hypertension (Pseudotumor cerebri) has been described as related to the reduction in steroid levels in Cushing's disease (CD), especially after surgical remission. Ketoconazole is a common and effective adjuvant therapy for hypercortisolism, but the major concern is liver enzyme dysfunction. We describe here the case of a 12-year old girl with CD who developed benign intracranial hypertension during treatment with ketoconazole. She presented headache, vomiting, a black spot on her right temporal visual field, and signs of elevated intracranial pressure. Pituitary image was normal on magnetic resonance image (MRI), and all symptoms improved after treatment with acetazolamide. We call attention to the diagnosis of this disorder in CD patients, especially children on ketoconazole treatment, because it could be confounded with adrenal insufficiency and lead to definitive severe visual impairment. Arq Bras Endocrinol Metab. 2011;55(4):284-7 SUMÁRIOHipertensão intracraniana benigna (Pseudotumor cerebral) tem sido descrita relacionada à redução dos níveis de esteroides séricos na doença de Cushing (DC), especialmente após a remissão cirúrgica. O cetoconazol é uma opção efetiva e de uso rotineiro como adjuvante na terapêutica do hipercortisolismo, tendo como paraefeito mais temido a toxicidade hepática. Relatamos o caso de uma menina com 12 anos de idade portadora de DC que desenvolveu hipertensão intracraniana benigna durante tratamento com cetoconazol. Apresentou-se com cefaleia, vômitos, comprometimento do campo visual temporal direito e sinais de hipertensão intracraniana. A ressonância magnética (RM) de hipófise era normal e todos os sinais e sintomas resolveram-se com uso de acetazolamida. Chamamos a atenção para esse diagnóstico nos pacientes com DC, especialmente crianças, em tratamento com cetoconazol, porque ele pode ser confundido com insuficiência adrenal e causar comprometimento visual severo e definitivo. Arq Bras Endocrinol Metab. 2011;55(4):284-7

Interdisciplinary therapy is necessary to personalize treatment and satisfy the patient's desire and need for appropriate and effective management.

Acromegaly has several complications on the cardiovascular system, especially hypertension. Objectives: To evaluate clinical characteristics and laboratorial cardiovascular risk markers of a group of patients with acromegaly and to determine whether they are correlated with presence of hypertension and disease activity. Study design: Uncontrolled cross-sectional study. Patients and Methods: Forty-four patients with active or inactive acromegaly being followed at the Neuroendocrinology Clinic of the HCPA were submitted to clinical assessment, laboratory tests (biochemical parameters for acromegaly control, lipid profile, renin, aldosterone, 24-hour microalbuminuria, ultrasensitive C-reactive protein), and echocardiography. Results: The prevalence rates found in the sample were as follows: active acromegaly, 40.9%; hypertension, 56.8%; diabetes mellitus, 18.2%; obesity, 29.5%. Patients with active disease did not have the highest number of cardiovascular risk factors when compared with healed individuals. There were no correlations between disease activity and presence of hypertension, renin and aldosterone levels, or us-CRP. Patients with left ventricular hypertrophy had lower levels of GH and IGF-1 (nonsignificant p). There was correlation between acromegaly activity and microalbuminuria levels and HOMA index. Conclusions: There is no greater aggregation of cardiovascular risk factors in active acromegaly; there is correlation between disease activity and nontraditional cardiovascular risk parameters -microalbuminuria and insulin resistance.

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