98.4.13-Acromegaly

Dr.Zahra Davoudi

Endocrinology department of Loghman Hakim Hospital, Shahid Beheshti University of Medical Sciences

Unusual case of

                    Acromegaly

Case presentation

A 22-year-old female presented to the endocrinology clinic with CC::

• Weight gain
• Menstrual disorder (oligomenorrhea)since 1 year ago

The menstruation onset age was 13 years old has been regular since the beginning

• Excessive body hair (hirsutism),
•  Hair loss

Physical Examination

• Vital sign was stable,
• weight: 66 kg, height:164 cm, BMI:23.68,
• The Ferriman-Gallwey score for hirsutism was> 15
• Frontal region hair loss,  thin hair,
• Acanthosis nigricans behind the neck
• There was no finding in favor Cushing syndrome
• According to the hyperandrogenism feature and mensturation disorder,
• And history of recent rhinoplasty and
• (no  other signs and symptoms related to acromegaly)
• For R/O polycystic ovarian disease (PCOD) and other related disorder
•  lab tests (IGF1) and pelvic sonography were requested

Results of lab tests :

• FSH: 5 IU/L,
• LH: 14 IU/L,
• Testosterone: 0.59 ng/ml,
• 17OHP:1.2 ng/ml,
• TSH: 2.6 mIU/l, T4:8 ug/dl
• PRL: 450 mIu/mL
• Insulin level: 12.5 μIU/ml,, FBS: 74 mg/dl
• IGF1:1140 ng/ml

Pelvic sonography::: PCOD