Recognizing the Diverse Clinical Presentations of Acromegaly: Insight from a Case Series

Abstract

Purpose: Acromegaly is an endocrine disease due to growth hormone excess with slowly developing manifestations and diverse clinical presentations. There are chances that patients may present with common clinical problems and the underlying endocrine condition is overlooked and diagnosis is delayed. This case series will discuss the presentation, clinical features and investigations of four acromegaly cases to increase the clinical skills of physicians so that an early diagnosis is made and treatment is initiated early. Methods: This is an observational study, where a series of four acromegaly cases, who presented to medicine inpatients or outpatients of Sylhet Women’s Medical College, Bangladesh. They were analyzed through detailed clinical features and, investigation findings. MRI brain was used as the main tool for diagnosis. Serum levels of growth hormone, IGF-1, TSH, ACTH, and prolactin were assessed in all. Other anterior pituitary hormone assays were selectively done. Ocular examinations were performed on all patients. Conclusion: Though a case series has lower value as medical evidence than systematic reviews and randomized clinical trials, it can help in generating future protocols of studies. This series emphasizes that a keen clinical eye of the physician can help in early diagnosis of acromegaly and thus an early MRI of brain based on clinical suspicion can ensure early treatment and prevent cardiovascular complications.