Pseudoacromegaly is a condition characterized by cutaneous manifestations of growth hormone excess but with normal growth hormone levels. This is described in patients with severe insulin resistance, pachydermoperiostitis, burnt out acromegaly and with intake of drugs like Minoxidil. Severe thyroid hormone deficiency rarely present with similar picture and the issue is further complicated in presence of pituitary hyperplasia. We report an unusual presentation of primary hypothyroidism with pseudoacromegaly and thyrotroph hyperplasia mimicking a pituitary macroadenoma. The thyrotroph hyperplasia resolved completely with levothyroxine therapy.
Objectives: Psoriasis is a systemic chronic inflammatory autoimmune disease. Psoriasis can lead to multiple complications and co-morbidities. It has also been observed that raised serum uric acid levels predispose to gouty arthritis and also thought to be a risk factor for cardiovascular mortality and morbidity. The basic aim of this study was to ascertain level of serum uric acid in patients with chronic plaque psoriasis and control cases which might be a useful tool for assessing the extent and severity of chronic plaque psoriasis. Study Design: Case control study. Setting: At Outpatient’s Department (OPD) of Department of Dermatology, PNS Shifa, Karachi. Period: From January 2013 to December 2016. Material & Methods: One hundred and ninety four (194) patients were taken in this study and 97 patients were biopsy proven cases of psoriasis and 97 other participants included as control cases reporting to OPD with other complaint like acne, hair fall and fungal infections. After written and informed consent, 5ml of venous blood was drawn in sterile syringe and using gel sample tube to see the serum uric acid levels. On the basis of laboratory reports the elevated serum uric acid level in psoriatic versus normal controls was recorded on a pre-designed proforma. Results: There were 54.6% (106/194) male and 45.4% (88/194) female. Elevated serum uric level was 4.5 times (Approximate of 4.46) more common in cases than control group (OR: 4.46 95%CI: 1.83 to 10.91). Conclusion: Raised levels of serum Uric acid have been seen frequently in psoriatic patients. Early treatment for higher levels of serum uric acid might play a critical role in the better treatment of psoriatic patients. These results revealed that serum uric acid concentration (SUAC) of psoriasis may play a vital role in assessing the complex multifactorial etiology of the psoriasis, severity and other possible metabolic factors.
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