Vidal Cortada J, Conget Donlo J I, Navarro Téllez M P, Halperin Rabinovic I, Vilardell Latorre E
Servicio de Endocrinología y Nutrición, Hospital Clínico y Provincial, Barcelona.
An Med Interna. 1995 Feb;12(2):76-8.
Diabetes mellitus is a frequent manifestation in patients with acromegaly and it can show up even before the latter manifests. Typically, the diabetes mellitus in these patients does not tend to develop ketosis. We present the case of a patient hospitalized due to diabetic ketoacidosis associated to a perianal abscess. Diabetes mellitus type I was rejected and the presence of insulin-resistance was verified. She required insulin therapy just for three months. The clinical, hormonal and radiological evaluation showed, three years latter, the presence of a hypophyseal tumor producing growth hormone. After performing a trans-sphenoidal adenomectomy, the insulin-therapy could be removed with a normal glycemic profile. This case of acromegaly demonstrates the relationship between growth hormone and glucose metabolism. It can be considered that the ketoacidosis was the first manifestation of the acromegaly, which is exceptional.
糖尿病是肢端肥大症患者的常见表现，甚至可能在肢端肥大症出现之前就表现出来。通常，这些患者的糖尿病不易发展为酮症。我们报告一例因糖尿病酮症酸中毒合并肛周脓肿住院的患者。排除了1型糖尿病，并证实存在胰岛素抵抗。她仅需胰岛素治疗三个月。三年后，临床、激素和影像学评估显示存在分泌生长激素的垂体瘤。经蝶窦腺瘤切除术后，血糖水平恢复正常，可停用胰岛素治疗。该例肢端肥大症病例证明了生长激素与糖代谢之间的关系。可以认为酮症酸中毒是肢端肥大症的首发表现，这种情况较为罕见。
