Title: Missed diagnosis of Acromegaly in a patient with Type 2 Diabetes Mellitus: A Case Report
Authors: Dr Suman Kumar Sahu, Dr Sanghamitra Sahoo, Dr Bijay Ketan Das
DOI: https://dx.doi.org/10.18535/jmscr/v9i12.08
Abstract
The early stages of acromegaly are characterized by slow and progressive acral overgrowth and coarse facial features without major systemic complications. In some acromegaly patients, diabetes mellitus is accompanied with insulin resistance. Here we report a case of 39 year old female presented with altered sensorium, provisionally diagnosed to be Type 2 DM with HHS. She had secondary amenorrhea for last 1 year. The patient had no acromegaly‑related complaints. Laboratory data revealed high blood levels of glucose and HbA1c. Physical examination revealed features of acromegaly. MRI disclosed pituitary macroadenoma and laboratory investigation indicated a high blood concentration of growth hormone and Insulin like growth factor 1. The patient was diagnosed with Type 2 Diabetes mellitus with acromegaly, and acromegaly associated exacerbation of Diabetes. The patient was treated with insulin, somatostatin analogues (Octreotide) and Dopamine agonist (Cabergoline). The case highlights the importance of insulin resistance, hyperglycemia and abnormal manifestations of face and feet in patients with acromegaly. In addition, these findings highlight the importance of the early diagnosis of acromegaly for preventing the consequences of inappropriate patient care.
Keywords: Acromegaly, Type 2 DM.
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