Primary hypothyroidism presenting as pseudoacromegaly

Kumar, K.V.S. Hari; Shaikh, Altamash; Anwar, Irfan; Prusty, Pitambar

doi:10.1007/s11102-011-0336-x

Cited by 14 publications

(12 citation statements)

References 9 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In other reported cases, chronic untreated primary hypothyroidism with pituitary hyperplasia has caused long term sequelae, with complete pituitary failure and panhypopituitarism with appearance of empty sella syndrome [7, 44]. Other confounding clinical scenarios have been reported with “pseudoacromegaly,” where patients had clinical signs and symptoms suggestive of acromegaly and imaging suggestive of pituitary adenoma; however a complete clinical history and biochemical evaluation revealed primary hypothyroidism [43, 50].…”

Section: Discussionmentioning

confidence: 99%

Pituitary Hyperplasia in Severe Primary Hypothyroidism: A Case Report and Review of the Literature

Shukla

Bulsara

Luthra

2019

Case Reports in Endocrinology

View full text Add to dashboard Cite

Pituitary hyperplasia is commonly present but remains largely undiagnosed in primary hypothyroidism. It is easily reversible with thyroid replacement therapy. If imaging is performed prior to biochemical evaluation, then patients may undergo pituitary surgery. We present the case of a 34-year-old female with profound primary hypothyroidism and secondary pituitary hyperplasia that resolved after thyroid hormone supplementation. We will discuss the current literature regarding pituitary hyperplasia in primary hypothyroidism in adults.

show abstract

Section: Discussionmentioning

confidence: 99%

Pituitary Hyperplasia in Severe Primary Hypothyroidism: A Case Report and Review of the Literature

Shukla

Bulsara

Luthra

2019

Case Reports in Endocrinology

View full text Add to dashboard Cite

show abstract

“…These latter patients have normal serum IGF-1 levels and reveal a suppressed serum GH following an oral glucose challenge. Conditions responsible for pseudoacromegaly include, among others, severe insulin resistance, pachydermoperiostitis, Ascher's syndrome, multiple neuromas syndrome, drug intake (e.g., Minoxidil, Phenytoin), and hypothyroidism [2, 3]. Pseudoacromegaly due to severe insulin resistance is due to supraphysiologic levels of insulin that stimulate growth through an intact mitogenic signaling pathway.…”

Section: Introductionmentioning

confidence: 99%

Acromegaloid Facial Appearance: Case Report and Literature Review

Ghazi

Khosla

Becker

2013

Case Reports in Endocrinology

View full text Add to dashboard Cite

Pseudoacromegaly is characterized by an acromegalic appearance without any abnormality of growth hormone function. It may be caused by several congenital and acquired conditions. One such condition is the acromegaloid facial appearance (AFA) syndrome. This condition has been described in approximately eight cases/families. It encompasses a spectrum of acromegaloid physical findings, normal growth hormone (GH) and insulin-like growth factor one (IGF-1) levels, and variable mode of inheritance. The most common physical findings are coarse facies, bulbous nose, and thickened lips. We present a case and a review of the literature on this illness. The patient is a 57-year-old woman who was referred to the endocrinology division for evaluation of suspected acromegaly. She had an acromegaloid appearance since birth as well as a terminal hypertrichosis. Her endocrine laboratory evaluation and chromosomal analyses were normal. AFA needs to be considered when evaluating any patient with pseudoacromegaly. Additional cases/families need to be identified in order to better understand the clinical spectrum, clinical implications, and mode of inheritance of AFA.

show abstract

“…The mean adenoma diameter was estimated at 8.1 ± 3.3 mm (range 5–13 mm), and mean age at diagnosis was 25.0 ± 8.8 years, ranging from 14 up to the maximum age of 44 (Table S3). Pituitary hyperplasia was described in 1 female with insulin‐mediated pseudoacromegaly 15 and in two males with primary hypothyroidism‐related pseudoacromegaly 16,17 …”

Section: Resultsmentioning

confidence: 99%

“…The adequate management of a pseudoacromegaly patient is much more than only ruling out acromegaly, as establishing the underlying diagnosis in a timely manner is key for the treatment of some disease-specific manifestations, but also to avoid a misdiagnosis or repetition of unnecessary investigations [17][18][19][20][21][22][23] ; moreover, it is important for the appropriate testing and treatment of affected family members, as many of these disorders are genetically inherited. 2 The mean delay in the diagnosis of the pseudoacromegaly condition since the appearance of the first acromegaloid symptoms was higher than 10 years.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Pseudoacromegaly—A challenging entity in the endocrine clinic: A systematic review

Marques,

Sapinho,

Korbonits

2024

Clinical Endocrinology

View full text Add to dashboard Cite

ObjectivePseudoacromegaly encompasses conditions with features of acromegaly/gigantism, but no growth hormone (GH) or insulin‐like growth factor‐1 (IGF‐1) excess. We aimed to review published pseudoacromegaly cases evaluated due to clinical suspicion of acromegaly.Design/PatientsPubMed/Medline search was conducted to identify reported pseudoacromegaly cases, which were systematically reviewed to ensure they met eligibility criteria: (1) presentation suggestive of acromegaly; (2) acromegaly excluded based on normal GH, IGF‐1 and/or GH suppression on oral glucose tolerance test (OGTT‐GH); (3) diagnosis of the pseudoacromegaly condition was established. Data were retrieved from each case and analysed collectively.ResultsOf 76 cases, 47 were males, mean ages at presentation and at first acromegaloid symptoms were 28 ± 16 and 17 ± 10 years, respectively. Most common conditions were pachydermoperiostosis (47%) and insulin‐mediated pseudoacromegaly (IMP) (24%). Acromegaloid facies (75%) and acral enlargement (80%) were the most common features. Measurement of random GH was reported in 65%, IGF‐1 in 79%, OGTT‐GH in 51%. GH excess was more frequently excluded based on two tests (53%). Magnetic resonance imaging (MRI) was performed in 30 patients, with pituitary adenoma or hyperplasia being reported in eight and three patients, respectively. Investigations differed between cases managed by endocrine and non‐endocrine specialists, the former requesting more often IGF‐1, OGTT‐GH and pituitary MRI.ConclusionsPseudoacromegaly is a challenging entity that may be encountered by endocrinologists. Pachydermoperiostosis and IMP are the conditions most often mimicking acromegaly. Adequate assessment of GH/IGF‐1 is crucial to exclude acromegaly, which may be better performed by endocrinologists. Pituitary incidentalomas are common and require careful judgement to prevent unnecessary pituitary surgery.

show abstract

Primary hypothyroidism presenting as pseudoacromegaly

Cited by 14 publications

References 9 publications

Pituitary Hyperplasia in Severe Primary Hypothyroidism: A Case Report and Review of the Literature

Pituitary Hyperplasia in Severe Primary Hypothyroidism: A Case Report and Review of the Literature

Acromegaloid Facial Appearance: Case Report and Literature Review

Pseudoacromegaly—A challenging entity in the endocrine clinic: A systematic review

Contact Info

Product

Resources

About