Endocrine Abstracts

Hair loss after surgical treatment for acromegaly has been rarely described. We report a case of a patient with acromegaly that presented with hair loss after surgical treatment.

We describe a case of a 73-year female that was diagnosed with acromegaly. Transesphenoidal surgery was performed with complete tumour resection and no immediate complications. Postoperative IGF -1, GH and OGTT for GH were measured at 12 weeks confirming biochemical remission. The rest of the pituitary axis remained within normal range. Four months after surgery the patient presented with diffuse scalp hair loss, predominantly in the frontoparietal area, and complete loss of eyebrows. She was diagnosed of a telogen effluvium. At the same time she was diagnosed with depression. We performed a basic laboratory evaluation, which ruled out other etiologies than might cause hair loss. Three months after the initial evaluation, she did not show signs of recovery neither in the frontal parietal area, nor in her eyebrows.

Studies have shown that IGF-1 may play an important roll in the development and preservation of the hair follicle. Hair loss has been reported as an adverse effect of somatostatin analog therapy. Even though the mechanisms are still unknown, a drop in the IGF-1 levels could be implicated in both cases. Due to the association between hair loss and the drop of IGF-1 levels, this event could be considered as an indirect sign of remission. It is important to assess the initial hair status to prevent low self-esteem that can cause depression and improve the knowledge of this entity. Questioning patients about hair loss could help us make an early diagnosis, understand its natural history, frequency and risk factors.

Keywords: hair loss, acromegaly, transesphenoidal surgery