From PCOS to Acromegaly: Diagnostic Challenges in a Young Female Patient | Chapter 2 | Medical Science: Updates and Prospects Vol. 4

 

Background: Hirsutism, though common in women of reproductive age, is classically associated with polycystic ovarian syndrome (PCOS). It is rarely seen as a prominent feature of acromegaly because of its lack of specificity and occurrence. Acromegaly is caused by chronic hypersecretion of growth hormone (GH) and insulin-like growth factor 1 (IGF-1). Diagnosis of acromegaly remains a challenge when the patient may have only subtle features of insulin resistance and PCOS in women.

 

Case Presentation: This study reports a case of a 28-year-old female with a 3-year duration of oligoamenorrhea and hirsutism. She was followed by a gynaecologist who retained the diagnosis of polycystic ovary syndrome (PCOS). After 5 years, the patient complained of increased hand, finger, and shoe size. She was referred to the endocrine department for suspicion of Acromegaly. Clinical examination revealed acromegaloidism features with mandibular prognathism and moderate macroglossia wic. Biological investigations were significant for elevated insulin-like growth factor 1 (IGF-1) level (774 ng/ml, normal: 98-290 ng/ml) and a growth hormone level not suppressed by a glucose challenge test. MRI brain revealed a pituitary macroadenoma (10.7x14 mm). The patient underwent an uncomplicated transsphenoidal resection of a pituitary macroadenoma. Immunohistochemistry demonstrated a GH tumour. The patient subsequently had normalisation of growth hormone dynamics and regular menstrual cycles.

 

Discussion: The cause of hirsutism in acromegaly is not well known. In acromegaly, chronic elevated growth hormone levels result in elevated total and free IGF-1. Patients with acromegaly are often insulin-resistant due to the insulin-antagonistic effects of elevated circulating growth hormone. GH decreases sex hormone binding globulin levels, which leads to increased free testosterone levels in patients with acromegaly despite normal testosterone levels.

 

Conclusion: This case highlights the importance of looking out for subtle features of acromegaly in patients with hirsutism and going for hormonal investigation to make the diagnosis of acromegaly at an earlier stage of the disease. Early diagnosis is critical to prevent the long-term morbidity and mortality associated with acromegaly, as it is a potentially life-threatening condition.

 

 

Author(s) Details

Manel Jemel Hadiji
National Institute of Nutrition and Food Technology Department of Endocrinology Tunis Tunisia, Manar University Tunis, Tunisia.

 

Mahdi Kalthoum
National Institute of Nutrition and Food Technology Department of Endocrinology Tunis Tunisia, Manar University Tunis, Tunisia.

 

Hajer Kandara
National Institute of Nutrition and Food Technology Department of Endocrinology Tunis Tunisia, Manar University Tunis, Tunisia.

 

Wafa Mimita
National Institute of Nutrition and Food Technology Department of Endocrinology Tunis Tunisia, Manar University Tunis, Tunisia.

 

Sonia Nagi
National Institute of Neurology Department of Neuroradiology Tunis Tunisia, Manar University Tunis, Tunisia.

 

Ines Kamoun
National Institute of Nutrition and Food Technology Department of Endocrinology Tunis Tunisia, Manar University Tunis, Tunisia.

 

Please see the book here :- https://doi.org/10.9734/bpi/msup/v4/6655

Comprehensive Review on a Complicated Endocrine Disorder (Acromegaly) | Chapter 12 | Current Practice in Medical Science Vol. 9

 This article's goal is to familiarise readers with acromegaly's symptoms, indicators, and treatments. Acromegaly is a condition that causes abnormalities in other metabolic systems as well as excessive body tissue growth. The anterior pituitary's oversecretion of growth hormone is what causes it. A benign (non-cancerous) tumour is typically what causes acromegaly, which most frequently affects people in their middle years. Acromegaly patients have joint pain, physical deformities, depth of voice, projecting lower jaw, huge hands and feet, oily skin, visual problems, and sexual dysfunction (impotence). Gigantism happens before the fusing of the growth plates, whereas acromegaly happens later. It is determined that any illness management approach must be patient-centered, improve the patient experience in healthcare, and reduce the burden of their treatment. The current study may be useful for doing systematic and focused research for more practical acromegaly management.

Author(s) Details:

Sanjita Das,
Noida Institute of Engineering and Technology (Pharmacy Institute), Plot No - 19, Knowledge Park - II, Greater Noida - 201306, Uttar Pradesh, India.

Divya,
Noida Institute of Engineering and Technology (Pharmacy Institute), Plot No - 19, Knowledge Park - II, Greater Noida - 201306, Uttar Pradesh, India.

Please see the link here: https://stm.bookpi.org/CPMS-V9/article/view/8019

A Review on Current Status and Perspectives of Pituitary Adenoma Nitroproteomics | Chapter 1 | Current Topics in Medicine and Medical Research Vol. 11

 Tumorigenesis is extensively associated with oxidative stress. A number of studies have been conducted in human pituitaries and adenomas on stable tyrosine nitration as a marker of oxidative damage. The biological features of the tumour were involved in nitrotyrosine sites found within the major protein domains or motifs. This paper reviews published studies on the characteristics of mass spectrometry of pituitary controls and adenomas in nitropeptides and nitroproteomics. The nitroproteomics approach used the current status of studies in human pituitary nitroproteomics, and future perspectives are checked. The first significant step for nitroproteomics studies is the enrichment of these low-abundance endogenous nitroproteins from human tissues or body fluid samples. In order to determine the amino acid sequence and locate the nitrotyrosine sites, mass spectrometry is the necessary method. To locate the nitrotyrosine site within the corresponding protein domains/motifs, bioinformatics analyses, including protein domain and motif analyses, are required. In order to discover signalling pathway networks involving nitroproteins from a systematically global perspective, system biology techniques, including pathway analysis, are essential. Future quantitative nitroproteomics may discover nitroprotein unique to pituitary adenoma (s). The impact of tyrosine nitration on the structure and functions of a protein can be strongly explained by structural biology techniques such as X-ray crystallography research. These studies will ultimately discuss tyrosine nitration pathways and biological roles in pituitary tumorigenesis and will establish nitroprotein biomarkers for pituitary adenomas and drug design targets for pituitary adenoma therapy. In the future, to discover the nitroprotein biomarker unique to each cell type of a pituitary adenoma and further examine the 3D structure of that nitroprotein, quantitative nitroproteomics of each cell type of a pituitary adenoma must be carried out. Moreover in order to identify body-fluid nitroproteins or nitropeptide patterns, it is important to establish quantitative nitroproteomics of body fluids (CSF and blood plasma) of pituitary adenoma patients.

Author(s) Details

Xianquan Zhan
University Creative Research Initiatives Center, Shandong First Medical University, 6699 Qingdao Road, Jinan, Shandong 250117, China, Key Laboratory of Cancer Proteomics of Chinese Ministry of Health, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, China and Hunan Engineering Laboratory for Structural Biology, Drug Design, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, China and State Local Joint Engineering Laboratory for Anticancer Drugs, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, China.

Xiaowei Wang
Key Laboratory of Cancer Proteomics of Chinese Ministry of Health, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, China, Hunan Engineering Laboratory for Structural Biology and Drug Design, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, China and State Local Joint Engineering Laboratory for Anticancer Drugs, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan 410008, China.

Dominic M. Desiderio
The Charles B. Stout Neuroscience Mass Spectrometry Laboratory, Department of Neurology, College of Medicine, University of Tennessee Health Science Center, 847 Monroe Avenue, Memphis, TN 38163, USA.
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