Hair, sweat and tears

Abdo, Sarah; Samaras, Katherine

doi:10.1136/bcr.05.2011.4177

Cited by 5 publications

(4 citation statements)

References 7 publications

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“…None presented with as overt and severe diabetes as in our case, though all four showed evidence of insulin resistance. Partial resolution of hirsutism, similar to our case, was noted in the one case report that discussed postsurgical resection outcomes (15).…”

Section: Discussionsupporting

confidence: 86%

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Acromegaly Presenting as Severe Hirsutism and Amenorrhea

Kraut

Lakoff

2018

AACE Clinical Case Reports

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Objective: The combination of hirsutism and amenorrhea is a frequent medical complaint that is generally benign but rarely can be a sign of significant underlying pathology. Methods: Case report and review of the literature. Results: We report here a case of a 22-year-old woman who presented to medical attention due to severe hirsutism, hyperandrogenism, and diabetes mellitus. On further investigations, she was found to have acromegaly, with an elevated insulin-like growth factor 1 (IGF-1) level (662 µg/L; normal, 95 to 397 µg/L) and a growth hormone level not suppressed by a glucose challenge test. A 7 × 7 mm anterior pituitary mammosomatotroph adenoma was identified and surgically resected, resulting in normalization of her IGF-1 level and partial resolution of her symptoms. Conclusion: Increased awareness of acromegaly in the differential diagnosis of hirsutism and menstrual irregularity could promote earlier diagnosis and treatment of this debilitating and progressive condition.

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Section: Discussionsupporting

confidence: 86%

“…Acromegaly is known to be associated with hirsutism, hyperandrogenism, and diabetes, although they are rarely the initial presentation of the condition. There are only four reported cases identified in our search of the literature, though none as young as in the case presented here (14)(15)(16)(17). See Table 1 for a comparison of the cases.…”

Section: Discussionmentioning

confidence: 82%

Acromegaly Presenting as Severe Hirsutism and Amenorrhea

Kraut

Lakoff

2018

AACE Clinical Case Reports

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“…Initial symptoms may be non-specific and include headache, joint pain, amenorrhoea, dental irregularities and sleep apnoea, while the characteristic signs of GH excess may take years to develop 2 3. The former limitation is well depicted in a patient case reported by Abdo et al ,4 where a patient who presented with hirsutism was later found to have acromegaly as the source of her excess hair growth. As the authors point out, the differential diagnosis for hirsutism is very broad and it is easy to simply attribute a common sign to a commonly associated cause.…”

Section: Discussionmentioning

confidence: 96%

What the mind knows but the eyes may still miss: reducing the ‘Acromegalic Window’

Foucault

2014

BMJ Case Reports

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A 46-year-old Asian man was referred to our endocrine unit (April 2013) by his general practitioner for investigation of a neck mass. Ultrasound scan of the neck and serum thyroid-stimulating hormone levels revealed a euthyroid multinodular goitre. He presented with symptoms of frequent headaches, polydypsia, polyuria, perspiration and night sweats and demonstrated classic physical features of acromegaly. In retrospect, the patient's medical history included encounters with numerous physicians from an array of specialties for over 20 years, mostly for symptoms well recognised to be attributed to growth hormone (GH) excess. Random insulin-like growth factor-1 level was elevated at 103 nmol/L (normal 13-37 nmol/L) and oral glucose tolerance test showed non-suppressible GH secretion (15.06 mIU/L at 120 min). MRI revealed a mildly enlarged pituitary gland. The patient has been referred for surgery. This case highlights that, even with classic features of acromegaly, there may be a wide-ranging 'Acromegalic Window' between first presentation and clinical suspicion to eventual diagnosis.

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“…Each of these cases presented with severe hirsutism, and only three of five had menstrual irregularities. Four of five of the cases had polycystic ovaries on ultrasound and one had normal pelvic ultrasound (7)(8)(9)(10).…”

Section: Discussionmentioning

confidence: 99%

Acromegaly: Ominous Cause of Polycystic Ovary Syndrome

2019

ARC Journal of Clinical Case Reports

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Hirsutism though common in women of reproductive age, is classically associated with polycystic ovarian syndrome (PCOS). It is rarely seen as a prominent feature of acromegaly because of its lack of specificity and occurrence. We report a case of 28-year-old female with 3 year duration of aligoamenorrhea and hirsutism. She was followed by a gynecologist who retains the diagnosis of polycystic ovary syndrome (PCOS). After 5 years the patient complaints of increased hand finger and shoes size. She was referred to endocrine department for suspicion of Acromegaly. Clinical examination revealed acromegaloidism features with mandibular prognathism and moderate macroglossia wic. Biological investigation were significant for elevated insulin-like growth factor 1 (IGF-1) level (774 ng/ml normal: 98-290 ng/ml) and a growth hormone level not suppressed by a glucose challenge test. MRI brain revealed a pituitary macroadenoma (10.7x14 mm). The patient underwent an uncomplicated trans-sphenoidal resection of a pituitary macroadenoma. Immunohistochemistry demonstrated a GH tumor. The patient subsequently had normalization of growth hormone dynamics and regular menstrual cycles. Our case highlights the importance of a lookout for subtle features of acromegaly in patients with hirsuitism and going for hormonal investigation to make the diagnosis of acromegaly at an earlier stage of the disease.

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Hair, sweat and tears

Cited by 5 publications

References 7 publications

Acromegaly Presenting as Severe Hirsutism and Amenorrhea

Acromegaly Presenting as Severe Hirsutism and Amenorrhea

What the mind knows but the eyes may still miss: reducing the ‘Acromegalic Window’

Acromegaly: Ominous Cause of Polycystic Ovary Syndrome

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