January - March 2012, Volume 8, Issue 1

Topsakal S, Akin F, Yerlikaya E, Korkmaz T

A Case of Acromegaly in the Presence of Coincidental Liver Cirrhosis

Acta Endo (Buc) 2012, 8 (1): 119-124
doi: 10.4183/aeb.2012.119

Context. Acromegaly is a rare and serious syndrome and commonly associated with pituitary neoplasm. Classic cause of acromegaly in adults is the tumors of the somatotrophs that secrete growth hormone. Cirrhosis is the end stage of chronic liver disease and commonly a cause of death. It is\r\ncharacterized by diffuse hepatic fibrosis resulting in altered construction of the lobular parenchyma with widespread connective tissue septae, circumscribed\r\nregenerative nodules of hepatocytes and anastomoses between vascular channels linking portal and central vessels.\r\nObjective. To report the simultaneous cases of acromegaly and cirrhosis.\r\nCase report. A 62-year old, male patient came to the hospital complaining of severe abdominal swelling. Laboratory and imaging findings were compatible with the\r\npresence of hepatitis B virus related cirrhosis together with acromegaly. In this case, he had high GH level but lower IGF-1 level because of hepatic failure which can\r\nimpair IGF-1 production by the liver. Definitive diagnosis was made by pituitary MR and a 1 cm in diameter tumor was\r\ndetected.\r\nConclusion. This paper showed that cirrhosis can result in a low IGF-I level in patients with acromegaly. There is no\r\nprevious report available of the in the presence of coincidental combination of acromegaly and cirrhosis in a patient.

Keywords: acromegaly, liver, cirrhosis

Correspondence: Senay Topsakal, Pamukkale University, Faculty of Medicine, Department of Endocrinology and Metabolism, Denizli, 20070, Turkey, e-mail: stopsakal@pau.edu.tr