Author Correction: Acromegaly

Colao, Annamaria; Grasso, Ludovica F. S.; Giustina, Andrea; Melmed, Shlomo; Chanson, Philippe; Pereira, Alberto M; Pivonello, Rosario

doi:10.1038/s41572-019-0129-5

Cited by 13 publications

(29 citation statements)

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“…If we used the cut-off of 1 ng/mL, as suggested, our patient would have IGF-1/GH discrepancy [12]. New data even suggest a cut-off of < 0.3 ng/mL to exclude this disease [16]. When a discrepancy of GH/IGF-1 value is found during a diagnosis, we should really pursue close follow-up [26].…”

Section: Discussionmentioning

confidence: 93%

“…There were increased IGF-1 values of 379-481 ng/mL (normal range < 269 mg/dL). In the first oral glucose tolerance test (OGTT) ( Table 2), our patient had impaired glucose tolerance (101 mg/dL glucose at 0 minutes, and 186 mg/dL at 2 hours), with GH at 0 minutes of 1.5 ng/mL and 0.92 ng/mL nadir (as we used an ultrasensitive assay -IMMULITE 2000 hGHwe could use a cut-off of a nadir serum < 0.3 ng/mL to exclude acromegaly [16]). As there was a high clinical suspicion of true acromegaly, we performed a second OGTT 10 months later (Table 3), which supported the diagnosis of diabetes (plasma glucose at 0 minutes of 120 mg/dL, and 204 mg/dL at 2 hours), and confirmed the diagnosis of acromegaly (GH of 0.98 ng/mL at 0 minutes, and 0.64 ng/mL nadir).…”

Section: Case Presentationmentioning

confidence: 99%

“…The fat mass ratio (FMR) by bone densitometry (% trunk fat mass/% lower limbs fat mass) was 1.02 (FMR in men ≥ 1.961 discriminates lipodystrophy [16]), without signs of osteoporosis (lumbar spine T score + 4.8, Z score + 4.6; femur T score + 4.2, Z score + 4.7).…”

Section: Case Presentationmentioning

confidence: 99%

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Acromegaly with congenital generalized lipodystrophy – two rare insulin resistance conditions in one patient: a case report

et al. 2020

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Background: Lipodystrophies are a group of diseases which are characterized by abnormal adipose tissue deposition and are frequently associated with metabolic changes. Congenital generalized lipodystrophy is an autosomal recessive syndrome, with a prevalence < 1:10 million. Acromegaly is a rare disease, secondary to the chronic hypersecretion of growth hormone and insulin-like growth factor-1, with characteristic metabolic and somatic effects. "Acromegaloidism" is a term used for patients who manifest clinical features of acromegaly, but do not present a demonstrable hormone growth hypersecretion. The extreme shortage of subcutaneous adipose tissues and muscle hypertrophy confer an acromegaloid-like appearance in these patients. Case presentation: We describe a case of a patient with the rare combination of Berardinelli-Seip congenital lipodystrophy and acromegaly; our patient is a 63-year-old white man, who was referred to an endocrinology consultation for suspected lipodystrophy. He had lipoatrophy of upper and lower limbs, trunk, and buttocks, with muscular prominence, acromegaloid facial appearance, large extremities, and soft tissue tumescence. In addition, he had dyslipidemia and prediabetes. His fat mass ratio (% trunk fat mass/% lower limbs fat mass) was 1.02 by densitometry and he also had hepatomegaly, with mild steatosis (from an abdominal ultrasound), and left ventricular hypertrophy (from an electrocardiogram). His first oral glucose tolerance test had growth hormone nadir of 0.92 ng/mL, and the second test, 10 months afterwards, registered growth hormone nadir of 0.64 ng/mL (growth hormone nadir < 0.3 ng/mL excludes acromegaly). Pituitary magnetic resonance imaging identified an area of hypocaptation of contrast product in relation to a pituitary adenoma and he was subsequently submitted to transsphenoidal surgical resection of the mass. A pathological evaluation showed pituitary adenoma with extensive expression of growth hormone and adrenocorticotropic hormone, as well as a rare expression of follicle-stimulating hormone and prolactin. A genetic study revealed an exon 3/exon 4 deletion of the AGPAT2 gene in homozygosity. Conclusions: Congenital generalized lipodystrophy is a rare disease which occurs with acromegaloid features. As far as we know, we have described the first case of genetic lipodystrophy associated with true acromegaly. Although this is a rare association, the presence of congenital generalized lipodystrophy should not exclude the possibility of simultaneous acromegaly.

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Section: Discussionmentioning

confidence: 93%

Section: Case Presentationmentioning

confidence: 99%

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Acromegaly with congenital generalized lipodystrophy – two rare insulin resistance conditions in one patient: a case report

et al. 2020

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“…Acromegaly, mostly caused by growth hormone-secreting pituitary adenoma, is an endocrine and metabolic disease characterized by excessive secretion of growth hormone (GH) and concomitant increases in insulin-like-growth factor 1 (IGF-1) levels, leading to progressive somatic disfigurement and organ overgrowth (1,2). Some studies have also demonstrated that acromegaly results in neurologic complications, such as peripheral neuropathy and cognitive dysfunction (3,4).…”

Section: Introductionmentioning

confidence: 99%

“…Some studies have also demonstrated that acromegaly results in neurologic complications, such as peripheral neuropathy and cognitive dysfunction (3,4). In most cases, acromegaly is caused by a growth hormone-secreting pituitary adenoma (2). Untreated patients with acromegaly have a reduced life expectancy due to cardiovascular, cerebrovascular disease, and respiratory diseases (5,6).…”

Section: Introductionmentioning

confidence: 99%

In Vivo Characterization of Cortical and White Matter Microstructural Pathology in Growth Hormone-Secreting Pituitary Adenoma

Yuan

Ying

et al. 2021

Front. Oncol.

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BackgroundThe growth hormone (GH) and insulin-like-growth factor 1 (IGF-1) axis has long been recognized for its critical role in brain growth, development. This study was designed to investigate microstructural pathology in the cortex and white matter in growth hormone-secreting pituitary adenoma, which characterized by excessive secretion of GH and IGF-1.Methods29 patients with growth hormone-secreting pituitary adenoma (acromegaly) and 31 patients with non-functional pituitary adenoma as controls were recruited and assessed using neuropsychological test, surface-based morphometry, T1/T2-weighted myelin-sensitive magnetic resonance imaging, neurite orientation dispersion and density imaging, and diffusion tensor imaging.ResultsCompared to controls, we found 1) acromegaly had significantly increased cortical thickness throughout the bilateral cortex (pFDR < 0.05). 2) T1/T2-weighted ratio in the cortex were decreased in the bilateral occipital cortex and pre/postcentral central gyri but increased in the bilateral fusiform, insular, and superior temporal gyri in acromegaly (pFDR < 0.05). 3) T1/T2-weighted ratio were decreased in most bundles, and only a few areas showed increases in acromegaly (pFDR < 0.05). 4) Neurite density index (NDI) was significantly lower throughout the cortex and bundles in acromegaly (pTFCE < 0.05). 5) lower fractional anisotropy (FA) and higher mean diffusivity (MD), axial diffusivity (AD) and radial diffusivity (RD) in extensive bundles in acromegaly (pTFCE < 0.05). 6) microstructural pathology in the cortex and white matter were associated with neuropsychological dysfunction in acromegaly.ConclusionsOur findings suggested that long-term persistent and excess serum GH/IGF-1 levels alter the microstructure in the cortex and white matter in acromegaly, which may be responsible for neuropsychological dysfunction.

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Multidisciplinary management of acromegaly: A consensus

Giustina

Barkhoudarian

Beckers

et al. 2020

Rev Endocr Metab Disord

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252

188

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The 13th Acromegaly Consensus Conference was held in November 2019 in Fort Lauderdale, Florida, and comprised acromegaly experts including endocrinologists and neurosurgeons who considered optimal approaches for multidisciplinary acromegaly management. Focused discussions reviewed techniques, results, and side effects of surgery, radiotherapy, and medical therapy, and how advances in technology and novel techniques have changed the way these modalities are used alone or in combination. Effects of treatment on patient outcomes were considered, along with strategies for optimizing and personalizing therapeutic approaches.Expert consensus recommendations emphasize how best to implement available treatment options as part of a multidisciplinary approach at Pituitary Tumor Centers of Excellence.

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Author Correction: Acromegaly

Cited by 13 publications

References 0 publications

Acromegaly with congenital generalized lipodystrophy – two rare insulin resistance conditions in one patient: a case report

Acromegaly with congenital generalized lipodystrophy – two rare insulin resistance conditions in one patient: a case report

In Vivo Characterization of Cortical and White Matter Microstructural Pathology in Growth Hormone-Secreting Pituitary Adenoma

Multidisciplinary management of acromegaly: A consensus

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