Plotuna Iulia-Ștefania, Balaş Melania, Golu Ioana, Amzăr Daniela, Cornianu Mărioara, Vărcus Flore, Vlad Adrian, Vlad Mihaela
Second Department of Internal Medicine, Discipline of Endocrinology, 'Victor Babes' University of Medicine and Pharmacy, 300041 Timisoara, Romania.
Department of Endocrinology, 'Pius Brinzeu' Emergency County Hospital, 300736 Timisoara, Romania.
Exp Ther Med. 2023 Aug 22;26(4):477. doi: 10.3892/etm.2023.12176. eCollection 2023 Oct.
Acromegaly is a rare disease, usually caused by a pituitary tumor. It typically exhibits slow evolution and can result in numerous complications. In the present case report, the patient presented with hyperthyroidism associated with ophthalmopathy and right nodular goiter. The laboratory tests revealed persistent high levels of phosphorus without an apparent cause. After ruling out common pathologies associated with this finding, a focus was placed on the clinical aspects associated with acromegaly, a rare cause of hyperphosphatemia. Laboratory tests and MRI confirmed the diagnosis. The patient underwent transsphenoidal surgery, but the disease remained active, thus medical treatment was initiated, to a poor initial response. Associated with acromegaly, two distinct thyroid pathologies were diagnosed: Toxic adenoma and Graves' disease. This case highlights the challenges in diagnosing and managing a rare endocrine pathology.
肢端肥大症是一种罕见疾病,通常由垂体肿瘤引起。其病程通常进展缓慢,并可导致多种并发症。在本病例报告中,患者表现为伴有眼病和右叶结节性甲状腺肿的甲状腺功能亢进。实验室检查显示磷水平持续升高但无明显原因。在排除与此发现相关的常见病理情况后,重点关注与肢端肥大症相关的临床方面,肢端肥大症是高磷血症的罕见病因。实验室检查和磁共振成像(MRI)确诊了该疾病。患者接受了经蝶窦手术,但疾病仍处于活跃状态,因此开始进行药物治疗,初期反应不佳。与肢端肥大症相关,诊断出两种不同的甲状腺疾病:毒性腺瘤和格雷夫斯病。本病例突出了诊断和管理罕见内分泌疾病的挑战。