Gurnurkar Shilpa, Patel Unnati, Seekford Jennifer, Carakushansky Mauri, Chegondi Madhuradhar
Pediatric Endocrinology, Nemours Children's Hospital, Florida, Orlando, USA.
Pediatrics/Critical Care Medicine, Carver College of Medicine, University of Iowa, Iowa City, USA.
Cureus. 2022 Nov 17;14(11):e31604. doi: 10.7759/cureus.31604. eCollection 2022 Nov.
Gigantism and acromegaly are most commonly caused by a growth hormone (GH)-secreting pituitary adenoma. Pediatric cases are diagnostically and therapeutically challenging due to their insidious nature. This article presents two adolescent females who were referred to the endocrinology clinic primarily for the evaluation of menstrual disorders rather than for concerns about GH excess. Patient one was a 16-year-old who presented with primary amenorrhea and tall stature, and patient two, a 15-year-old, presented with a history of irregular menstruation. Both patients were noted to have acromegalic features, and an extensive work-up confirmed GH-secreting pituitary adenomas. In addition, patient two had significant hyperprolactinemia. Transsphenoidal tumor resection was performed on both patients; patient one had a successful complete resection and achieved endocrine remission, while patient two underwent partial resection followed by a short clinical trial of pegvisomant without significant success. Improved clinical knowledge through case reports can assist with the early diagnosis and management of such rare pediatric conditions.
巨人症和肢端肥大症最常见的病因是分泌生长激素（GH）的垂体腺瘤。儿科病例因其隐匿性在诊断和治疗上具有挑战性。本文介绍了两名青春期女性，她们最初因月经紊乱而非生长激素过多问题被转诊至内分泌科门诊。患者一是一名16岁女性，表现为原发性闭经和身材高大；患者二是一名15岁女性，有月经不规律病史。两名患者均有肢端肥大症特征，全面检查证实为分泌生长激素的垂体腺瘤。此外，患者二有明显的高泌乳素血症。两名患者均接受了经蝶窦肿瘤切除术；患者一成功实现完全切除并达到内分泌缓解，而患者二接受了部分切除，随后进行了短疗程的培维索孟临床试验，但未取得显著成效。通过病例报告增进临床知识有助于此类罕见儿科疾病的早期诊断和管理。
