Obesity in a patient with acromegaly: a case report
G. D. Gabaidze,
M. A. Perepelova,
E. G. Przhiyalkovskaya,
E. A. Pigarova,
A. G. Kuzmin,
O. I. Vengrzhinovskaya,
A. M. Lapshina,
L. K. Dzeranova https://doi.org/10.14341/omet13182
Abstract
Acromegaly is a severe neuroendocrine disease characterized by excessive production of the growth hormone (GH). The slow development of symptoms increases the diagnostic search up to 15 years. Permanent effect of the growth hormone on the human body can cause structural and functional disorders of organs. The main complications of acromegaly include cardiovascular, respiratory, and musculoskeletal system dysfunction, as well as impaired carbohydrate metabolism and an increased risk of developing neoplasms.
Often, nonspecific symptoms of acromegaly can be masked by other pathologies or their complications, such as obesity. An increase in subcutaneous fat, increased blood pressure, joint pain, edema, and impaired carbohydrate and lipid metabolism are observed both in acromegaly and in obesity. An additional factor in the development of obesity as a complication of acromegaly is the development of sleep apnea, which triggers a series of pathological processes that ultimately lead to Pickwickian syndrome.
We present a clinical case of a patient with acromegaly and obesity, discussing the effects of excess body weight on the course of the underlying disease, the presence of complications, and an individual approach to treatment.
About the Authors
G. D. Gabaidze
Endocrinology research centre
Russian Federation
Competing Interests:
Russian Federation
Georgy D. Gabaidze.
11 Dm. Ulyanova street, 117292 Moscow
Competing Interests:
None
M. A. Perepelova
Endocrinology research centre
Russian Federation
Competing Interests:
Russian Federation
Margarita A. Perepelova - MD.
Moscow
Competing Interests:
None
E. G. Przhiyalkovskaya
Endocrinology research centre
Russian Federation
Competing Interests:
Russian Federation
Elena G. Przhiyalkovskaya - MD, PhD.
Moscow
Competing Interests:
None
E. A. Pigarova
Endocrinology research centre
Russian Federation
Competing Interests:
Russian Federation
Ekaterina A. Pigarova - MD, PhD.
Moscow
Competing Interests:
Е.А. Пигарова — член редакционной коллегии журнала «Ожирение и метаболизм»
A. G. Kuzmin
Endocrinology research centre
Russian Federation
Competing Interests:
Russian Federation
Anatoly G. Kuzmin - MD, PhD.
Moscow
Competing Interests:
None
O. I. Vengrzhinovskaya
Endocrinology research centre
Russian Federation
Competing Interests:
Russian Federation
Oksana I. Vengrzhinovskaya - MD.
Moscow
Competing Interests:
None
A. M. Lapshina
Endocrinology research centre
Russian Federation
Competing Interests:
Russian Federation
Anastasia M. Lapshina - forensic pathologist, PhD.
Moscow
Competing Interests:
None
L. K. Dzeranova
Endocrinology research centre
Russian Federation
Competing Interests:
Russian Federation
Larisa K. Dzeranova - MD, PhD.
Moscow
Competing Interests:
Л.К. Дзеранова — заведующая редакцией журнала «Ожирение и метаболизм»
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Supplementary files
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1. Figure 1. Brain MRI scan with intravenous contrast of the parient D.: Multinodular tumor of nonhomogenous structure in the sella, suprasellar cistern, bottom of the 3rd ventricle, right cavernous sinus, sinuses of the sphenoid bone, 36x33x26 mm in size (vertical – transverse – anteroposterior), the tumor deforms, displaces and compresses the optic chiasm, deforms th medial wall of the left cavernous sinus, with less intensive contrast accumulation compared to the anterior pituitary. | |
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2. Figure 2. Immunohistochemical analysis of the tissue of the pituitary adenoma of the patient D. a — staining of the cytoplasm of the tumor cells with GH antibodies; b — Ki-67. | |
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3. Figure 3. a, c — “acromegaloid” appearance changes of the patient D; b — excessive subcutaneous and visceral fat | |
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4. Figure 4. Brain MRI scan with intravenous contrast of the patient D: cystic-solid tumor of irregular shape (with predominance of cystic compenent) in the sella with para-(D, Knosp 2), ante- infrasellar growth, 18x14x20 mm in size (vertical – transverse – anteroposterior), the solid component accumulates the contrast slower than the anterior pituitary | |
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5. Figure 5. Cardiorespiratory test of the patient D. with SOMNOcheck micro CARDIO device with the registration of the nasal breathing with the nasal cannula, snoring, pulse and saturation | |
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For citations:
Gabaidze G.D., Perepelova M.A., Przhiyalkovskaya E.G., Pigarova E.A., Kuzmin A.G., Vengrzhinovskaya O.I., Lapshina A.M., Dzeranova L.K. Obesity in a patient with acromegaly: a case report. Obesity and metabolism. 2024;21(3):331-338. (In Russ.) https://doi.org/10.14341/omet13182
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