A Case of Acromegaly with Graves' Disease.
- Author:
Jae Hoon CHUNG
;
Kwang Won KIM
;
Byoung Joon KIM
;
Sung Hoon KIM
;
Myung Sik LEE
;
Moon Gyu LEE
;
Yong Ki MIN
;
Jong Hyun KIM
;
Eun Young OH
;
Yun Jae CHUNG
;
Sang Soo BAE
- Publication Type:Case Report
- Keywords:
Acromegaly;
Graves disease
- MeSH:
Acromegaly*;
Adenoma, Acidophil;
Adult;
Female;
Glucose;
Goiter;
Graves Disease*;
Humans;
Hyperthyroidism;
Insulin-Like Growth Factor I;
Magnetic Resonance Imaging;
Pituitary Gland;
Prolactin;
Thyroid Gland
- From:Journal of Korean Society of Endocrinology
1998;13(3):432-438
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Goiter is present in 25-50% of patients with acromegaly, which probably results from IGF- I stimulation of thyroid cell growth. These goiters are usually non-toxic but there have been well documented cases of co-existent hyperthyroidism and acromegaly. Graves disease with acromegaly has been rarely reported compared with the other type of hyperthyroidism due to increased tumoral secretion of TSH. We experienced a 44-year-old woman who presented with Graves disease and acromegaly. Basal serum GH and IGF-I concentrations were 10.8 pg/L and 571.82 ng/mL, respectively (reference value: (5 mg/L and 130-354 ng/mL, respectively). GH was not suppressed less than 2 pg/L during oral glucose loading test. GH was stimulated by TRH. Postcontrast sellar MRI demonstrated ovoid-shaped low signal intensity nodule measuring O.8 cm in diameter in left side of pituitary gland. Thyroid scan(131I) showed enlarged thyroid with increased radioiodine uptake (61.3%). Histologic examination showed acidophilic adenoma. GH and prolactin were positive on immunohistochemical staining. GH was suppressed less than 2.26 mg/L by oral glucose loading following operation. The patient has been followed with antithyroid drug(PTU) medication after operation(TSA).
