ISSN 1470-3947 (print) | ISSN 1479-6848 (online)

Endocrine Abstracts (2019) 63 P275 | DOI: 10.1530/endoabs.63.P275

Acromegaly: ominous cause of hirsutism

Manel Jemel1,2, Mahdi Khalthoum1, Hajer Kandara1,2, Meriem Stambouli1, Sonia Nagi2,3, Leila Mansouri1 & Ines Kammoun1,2

1National Institute of Nutrition and Food Technology Department of Endocrinology, Tunis, Tunisia; 2Manar University Tunis, Tunis, Tunisia; 3National Institute of Neurology and Food Department of Neuroradiology, Tunis, Tunisia.

Hirsutism though common in women of reproductive age, is classically associated with polycystic ovarian syndrome (PCOS). It is rarely seen as a prominent feature of acromegaly because of its lack of specificity and occurrence. We report a case of 28-year-old female with 3 year duration of aligoamenorrhea and hirsutism. She was followed by a gynecologist who retains the diagnosis of polycystic ovary syndrome (PCOS). After 5 years the patient complaints of increased hand finger and shoes size. She was referred to endocrine department for suspicion of Acromegaly. Clinical examination revealed acromegaloidism features with mandibular prognathism and moderate macroglossia wic. Biological investigation were significant for elevated insulin-like growth factor 1 (IGF-1) level (774 ng/ml normal: 98–290 ng/ml) and a growth hormone level not suppressed by a glucose challenge test. MRI brain revealed a pituitary macroadenoma (10.7×14 mm). The patient underwent an uncomplicated trans-sphenoidal resection of a pituitary macroadenoma. Immunohistochemistry demonstrated a GH tumor. The patient subsequently had normalization of growth hormone dynamics and regular menstrual cycles. Our case highlights the importance of a lookout for subtle features of acromegaly in patients with hirsuitism and going for hormonal investigation to make the diagnosis of acromegaly at an earlier stage of the disease.

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