IDDM Accompanied by a Growth Hormone-Producing Pituitary Adenoma: A case report
- Fumio Otsuka, MD,
- Toshio Ogura, MD,
- Takayoshi Yamauchi, MD,
- Kenichi Shikata, MD,
- Jingo Kageyama, MD and
- Hirofumi Makino, MD
- Department of Medicine III, Okayama University Medical School, Okayama University Okayama, Japan
- Health and Medical Center, Okayama University Okayama, Japan
- Department of Nursing, School of Health Sciences, Okayama University Okayama, Japan
- Address correspondence and reprint requests to Fumio Otsuka, MD, Department of Medicine III, Okayama University Medical School, 2–5–1 Shikata-cho, Okayama 700, Japan.
Abstract
CASE HISTORY A 30-year-old Japanese man who presented with recurrent ketoacidosis caused by IDDM was found to have increased secretion of growth hormone (GH). On initial cranial magnetic resonance imaging (MRI), no pituitary lesion was detected; however, a pituitary microadenoma was found 2 years later during a repeat MRI. In spite of the hypersecretion of GH, serum IGF-I was dramatically suppressed. Transsphenoidal surgery was performed to resect the pituitary tumor that was histologically an acidophilic pituitary adenoma. Although the GH excess rapidly improved postoperatively, the IGF-I level remained low. Subsequent insulin therapy initiated 1 year after the operation elevated the serum IGF-I level to within the normal range.
DISCUSSION The first case of coexistent IDDM and a GH-producing pituitary adenoma suggests that patients with uncontrolled IDDM may develop GH hypersecretion. Furthermore, the low IGF-I levels may be closely associated with the GH excess and with the development or progression of GH-secreting pituitary adenomas.
- Received April 7, 1997.
- Revision received August 27, 1997.
- Accepted August 27, 1997.
- Copyright © 1997 by the American Diabetes Association
