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Pathogenic relations between metabolic and gynecologic disorders in acromegaly: a clinical case report

https://doi.org/10.14341/omet2017359-63

Abstract

Acromegaly is a neuroendocrine disorder with multiple comorbidities. In this article, we present a patient with long-term active acromegaly, without clinical remission after repeated neurosurgery and long-term treatment with somatostatin analogue. After the first neurosurgical treatment, cyclic ovarian function improved. Taken together with progressing metabolic disorders, it led to clinical manifestation of adenomyosis, which presented by algomenorrhea, menometrorrhagia and severe anemia. Due to clinical manifestation and extent of the disease, the patient underwent hysterectomy. Histologically we observed adenomyosis II with 2/3 myometrialpenetration. This clinical case highlights the importance of gynecological assessment among patients with acromegaly of late reproductive and premenopausal period.

About the Authors

Alexander S. Lutsenko

Endocrinology Research Centre


Russian Federation

research scientist of neuroendocrinology and bone diseases department


Competing Interests:

Authors declare no conflict of interest



Svetlana Yu. Vorotnikova

Endocrinology Research Centre


Russian Federation

Postgraduate student


Competing Interests:

Authors declare no conflict of interest



Irina V. Stanoevich

Endocrinology Research Centre


Russian Federation

Sc.D.


Competing Interests:

Authors declare no conflict of interest



Tatiana S. Zenkova

Endocrinology Research Centre


Russian Federation

PhD


Competing Interests:

Authors declare no conflict of interest



Vilen N. Azizyan

Endocrinology Research Centre


Russian Federation

PhD


Competing Interests:

Authors declare no conflict of interest



Andrey Yu. Grigoriev

Endocrinology Research Centre


Russian Federation

Sc.D.


Competing Interests:

Authors declare no conflict of interest



Zhanna E. Belaya

Endocrinology Research Centre


Russian Federation

Sc.D.


Competing Interests:

Authors declare no conflict of interest



References

1. Молитвословова Н.Н. Акромегалия: современные достижения в диагностике и лечении // Проблемы эндокринологии 2011. – Т. 57. – №1. – С.46-59 [Molitvoslovova NN. Acromegaly: recent progress in diagnostics and treatment. Problems of endocrinology. 2011;57(1):46-59. (In Russ)] doi: 10.14341/probl201157146-59

2. Воротникова С.Ю., Пигарова Е.А., Дзеранова Л.К. Метаболические эффекты гормона роста. Ожирение и метаболизм. – 2011. – Т.8. – № 4. – с. 55-59. [Vorotnikova SYu, Pigarova EA, Dzeranova LK. Metabolicheskie effekty gormona rosta. Obesity and metabolism. 2011;8(4):55-59. (In Russ.)] doi: 10.14341/2071-8713-5308

3. Katznelson L, Atkinson J, Cook D, et al. American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Diagnosis and Treatment of Acromegaly-2011 Update. Endocr Pract. 2011;17(Supplement 4):1-44. doi: 10.4158/ep.17.s4.1

4. Dal J, Feldt-Rasmussen U, Andersen M, et al. Acromegaly incidence, prevalence, complications and long-term prognosis: a nationwide cohort study. European Journal of Endocrinology. 2016;175(3):181-190. doi: 10.1530/eje-16-0117

5. Melmed S. New therapeutic agents for acromegaly. Nature Reviews Endocrinology. 2015. doi: 10.1038/nrendo.2015.196

6. Дильман В.М. Эндокринологическая онкология. – ЛО.: Медицина;1983. [Dil'man VM. Endokrinologicheskaya onkologiya. Leningrad region: Meditsina; 1983.(In Russ.)]

7. Abreu A, Tovar AP, Castellanos R, et al. Challenges in the diagnosis and management of acromegaly: a focus on comorbidities. Pituitary. 2016;19(4):448-457. doi: 10.1007/s11102-016-0725-2

8. Webb SM, Badia X. Quality of Life in Acromegaly. Neuroendocrinology. 2015;103(1):106-111. doi: 10.1159/000375451

9. Colao A, Ferone D, Marzullo P, Lombardi G. Systemic Complications of Acromegaly: Epidemiology, Pathogenesis, and Management. Endocr Rev. 2004;25(1):102-152. doi: 10.1210/er.2002-0022

10. Holdaway IM, Bolland MJ, Gamble GD. A meta-analysis of the effect of lowering serum levels of GH and IGF-I on mortality in acromegaly. European Journal of Endocrinology. 2008;159(2):89-95. doi: 10.1530/eje-08-0267

11. Katznelson L, Laws ER, Melmed S, et al. Acromegaly: An Endocrine Society Clinical Practice Guideline. J Clin Endocr Metab. 2014;99(11):3933-3951. doi: 10.1210/jc.2014-2700

12. Abu Dabrh A, Asi N, Farah W, et al. Radiotherapy vs. Radiosurgery in Treating Patients with Acromegaly: Systematic Review and Meta-Analysis. Endocr Pract. 2015(aop):1-33. doi: 10.4158/ep14574.ra

13. Станоевич И.В. Доброкачественные гиперпластические заболевания матки: патогенез, диагностика, лечение и профилактика: Дис. … док. мед. наук. – Москва; 2013. [Stanoevich IV. Dobrokachestvennye giperplasticheskie zabolevaniya matki: patogenez, diagnostika, lechenie i profilaktika [dissertation]. Moscow; 2013 (In Russ)]

14. Dreval AV, Trigolosova IV, Misnikova IV, et al. Prevalence of diabetes mellitus in patients with acromegaly. Endocrine Connections. 2014;3(2):93-98. doi: 10.1530/ec-14-0021

15. Ramos-Leví AM, Marazuela M. Cardiovascular comorbidities in acromegaly: an update on their diagnosis and management. Endocrine. 2017;55(2):346-359. doi: 10.1007/s12020-016-1191-3

16. Pivonello R, Auriemma RS, Grasso LFS, et al. Complications of acromegaly: cardiovascular, respiratory and metabolic comorbidities. Pituitary. 2017;20(1):46-62. doi: 10.1007/s11102-017-0797-7

17. Потешкин Ю.Е., Пронин В.С., Мельниченко Г.А., и др. Влияние избытка гормона роста и ИФР-1 на костно-суставную систему при акромегалии //Актуальная эндокринология. 2015. – №.10. – С. 1-30. [Poteshkin Y, Pronin VS, Melnichenko GA, et al. Growth hormone and IGF-1 effects on articular and skeletal system in acromegaly. Relev Endocrinol. 2015;(10):1-30. (In Russ)] doi: 10.18508/endo3539

18. Олейник О.В., Молитвословова Н.Н. Потенциальные предикторы и частота развития новообразований щитовидной железы и желудочно-кишечного тракта у пациентов с акромегалией //Проблемы эндокринологии. – 2015. – Т.61. – №.2. – C. 4-7 [Oleinik OV, Molitvoslovova NN. Potential predictors and the frequency of development of thyroid and gastrointestinal neoplasms in the patients presenting with acromegaly. Problems of Endocrinology. 2015;61(2):4-7 (In Russ.)]. doi: 10.14341/probl20156124-7

19. Чхиквадзе, В., Станоевич, У., Дехисси, Е., и др. Роль адипокинов в прогрессировании колоректального рака.//Врач – 2015. – №6. – С. 61-63. [Chkhikvadze V, Stanoevich U, Dekhissi E, et al. Role of adipokines in the progression of colorectal cancer. Vrach. 2015;(6):61-63. (In Russ.)]

20. Grynberg M, Salenave S, Young J, Chanson P. Female Gonadal Function before and after Treatment of Acromegaly. J Clin Endocr Metab. 2010;95(10):4518-4525. doi: 10.1210/jc.2009-2815.

21. Пронин А.В., Кирющенков А.П., Мельниченко Г.А., и др. Репродуктивная система женщин с акромегалией. //Вестник репродуктивного здоровья. – 2011. – №. 1. – С.32-39 [Pronin AV, Kiryushchenkov AP, Mel'nichenko GA, et al. Reproduktivnaya sistema zhenshchin s akromegaliei. Vestnik reproduktivnogo zdorov'ya. 2011;1:32-39.]

22. Зайдиева Я.З., Рифатова А.В. Акромегалия у женщин: взгляд гинеколога. //Российский вестник акушера-гинеколога. – 2014. – Т. 14. – №. 3. – С. 38-42. [Zaidieva YaZ, Rifatova AV, Acromegaly in women: A gynecologist's opinion. Rossiyskiy vestnik akushera-ginekologa. 2014;14(3): 38-42 (In Russ)]


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Review

For citations:


Lutsenko A.S., Vorotnikova S.Yu., Stanoevich I.V., Zenkova T.S., Azizyan V.N., Grigoriev A.Yu., Belaya Zh.E. Pathogenic relations between metabolic and gynecologic disorders in acromegaly: a clinical case report. Obesity and metabolism. 2017;14(3):59-63. (In Russ.) https://doi.org/10.14341/omet2017359-63

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ISSN 2071-8713 (Print)
ISSN 2306-5524 (Online)