Cargando…

Acromegaly Initially Presenting with Severe Infectious Diseases: A Case Report

A 39-year-old man presented with worsening fever, cough, and fatigue. He was immediately admitted to the intensive care unit (ICU) and was found to have sepsis, septic pulmonary embolism, right empyema, liver abscess, pyelonephritis, and a prostate abscess, with background diabetes mellitus. While r...

Descripción completa

Detalles Bibliográficos
Autores principales: Tani, Eriko, Hirashima, Tomonori, Hasegawa, Takamasa, Aohara, Daisuke, Oshima, Yuri, Sakurai, Yusuke, Hirai, Kaho, Yoshimoto, Naoki, Nishida, Mana, Tateishi, Yu, Minami, Kenichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Japan Medical Association 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8827133/
https://www.ncbi.nlm.nih.gov/pubmed/35224284
http://dx.doi.org/10.31662/jmaj.2021-0150
_version_ 1784647565022593024
author Tani, Eriko
Hirashima, Tomonori
Hasegawa, Takamasa
Aohara, Daisuke
Oshima, Yuri
Sakurai, Yusuke
Hirai, Kaho
Yoshimoto, Naoki
Nishida, Mana
Tateishi, Yu
Minami, Kenichi
author_facet Tani, Eriko
Hirashima, Tomonori
Hasegawa, Takamasa
Aohara, Daisuke
Oshima, Yuri
Sakurai, Yusuke
Hirai, Kaho
Yoshimoto, Naoki
Nishida, Mana
Tateishi, Yu
Minami, Kenichi
author_sort Tani, Eriko
collection PubMed
description A 39-year-old man presented with worsening fever, cough, and fatigue. He was immediately admitted to the intensive care unit (ICU) and was found to have sepsis, septic pulmonary embolism, right empyema, liver abscess, pyelonephritis, and a prostate abscess, with background diabetes mellitus. While receiving treatment, an ICU nurse noticed that the patient’s toe tips were too large to fit the clamp device of pulse oximeters. Thus, we re-examined the patient and confirmed that he had clinical features indicative of acromegaly including bulging eyebrows, enlarged nose and lips, large feet, and prognathism. He and his family had not noticed these features except for his enlarged feet. We evaluated the patient further for acromegaly, and a pituitary mass was detected via contrast-enhanced head magnetic resonance imaging. Whole-body computed tomography also revealed thickened heel pads, cauliflower deformity, frontal sinus enlargement, sella turcica enlargement, and mandibular malocclusion. A 75 g oral glucose tolerance test was performed to investigate abnormal secretion of growth hormone (GH), and the results revealed a paradoxical increase in GH levels. The patient was then diagnosed with acromegaly according to the clinical guidance of the Japan Endocrine Society. Acromegaly develops slowly; thus, to improve patients’ prognoses, physicians including internists, family physicians, and endocrinologists should include acromegaly in their differential when signs are apparent.
format Online
Article
Text
id pubmed-8827133
institution National Center for Biotechnology Information
language English
publishDate 2021
publisher Japan Medical Association
record_format MEDLINE/PubMed
spelling pubmed-88271332022-02-25 Acromegaly Initially Presenting with Severe Infectious Diseases: A Case Report Tani, Eriko Hirashima, Tomonori Hasegawa, Takamasa Aohara, Daisuke Oshima, Yuri Sakurai, Yusuke Hirai, Kaho Yoshimoto, Naoki Nishida, Mana Tateishi, Yu Minami, Kenichi JMA J Case Report A 39-year-old man presented with worsening fever, cough, and fatigue. He was immediately admitted to the intensive care unit (ICU) and was found to have sepsis, septic pulmonary embolism, right empyema, liver abscess, pyelonephritis, and a prostate abscess, with background diabetes mellitus. While receiving treatment, an ICU nurse noticed that the patient’s toe tips were too large to fit the clamp device of pulse oximeters. Thus, we re-examined the patient and confirmed that he had clinical features indicative of acromegaly including bulging eyebrows, enlarged nose and lips, large feet, and prognathism. He and his family had not noticed these features except for his enlarged feet. We evaluated the patient further for acromegaly, and a pituitary mass was detected via contrast-enhanced head magnetic resonance imaging. Whole-body computed tomography also revealed thickened heel pads, cauliflower deformity, frontal sinus enlargement, sella turcica enlargement, and mandibular malocclusion. A 75 g oral glucose tolerance test was performed to investigate abnormal secretion of growth hormone (GH), and the results revealed a paradoxical increase in GH levels. The patient was then diagnosed with acromegaly according to the clinical guidance of the Japan Endocrine Society. Acromegaly develops slowly; thus, to improve patients’ prognoses, physicians including internists, family physicians, and endocrinologists should include acromegaly in their differential when signs are apparent. Japan Medical Association 2021-12-24 2022-01-17 /pmc/articles/PMC8827133/ /pubmed/35224284 http://dx.doi.org/10.31662/jmaj.2021-0150 Text en Copyright © Japan Medical Association https://creativecommons.org/licenses/by/4.0/JMA Journal is an Open Access journal distributed under the Creative Commons Attribution 4.0 International License. To view the details of this license, please visit (http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) ).
spellingShingle Case Report
Tani, Eriko
Hirashima, Tomonori
Hasegawa, Takamasa
Aohara, Daisuke
Oshima, Yuri
Sakurai, Yusuke
Hirai, Kaho
Yoshimoto, Naoki
Nishida, Mana
Tateishi, Yu
Minami, Kenichi
Acromegaly Initially Presenting with Severe Infectious Diseases: A Case Report
title Acromegaly Initially Presenting with Severe Infectious Diseases: A Case Report
title_full Acromegaly Initially Presenting with Severe Infectious Diseases: A Case Report
title_fullStr Acromegaly Initially Presenting with Severe Infectious Diseases: A Case Report
title_full_unstemmed Acromegaly Initially Presenting with Severe Infectious Diseases: A Case Report
title_short Acromegaly Initially Presenting with Severe Infectious Diseases: A Case Report
title_sort acromegaly initially presenting with severe infectious diseases: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8827133/
https://www.ncbi.nlm.nih.gov/pubmed/35224284
http://dx.doi.org/10.31662/jmaj.2021-0150
work_keys_str_mv AT tanieriko acromegalyinitiallypresentingwithsevereinfectiousdiseasesacasereport
AT hirashimatomonori acromegalyinitiallypresentingwithsevereinfectiousdiseasesacasereport
AT hasegawatakamasa acromegalyinitiallypresentingwithsevereinfectiousdiseasesacasereport
AT aoharadaisuke acromegalyinitiallypresentingwithsevereinfectiousdiseasesacasereport
AT oshimayuri acromegalyinitiallypresentingwithsevereinfectiousdiseasesacasereport
AT sakuraiyusuke acromegalyinitiallypresentingwithsevereinfectiousdiseasesacasereport
AT hiraikaho acromegalyinitiallypresentingwithsevereinfectiousdiseasesacasereport
AT yoshimotonaoki acromegalyinitiallypresentingwithsevereinfectiousdiseasesacasereport
AT nishidamana acromegalyinitiallypresentingwithsevereinfectiousdiseasesacasereport
AT tateishiyu acromegalyinitiallypresentingwithsevereinfectiousdiseasesacasereport
AT minamikenichi acromegalyinitiallypresentingwithsevereinfectiousdiseasesacasereport