Assuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/fisiopatologia , Hiperglicemia/tratamento farmacológico , Hiperglicemia/etiologia , Quimioterapia Combinada , Hemoglobinas Glicadas/análise , Humanos , Hiperglicemia/diagnóstico , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Metformina/uso terapêuticoRESUMO
Tumours that cause ectopic acromegaly can do so through the secretion of GH or GHRH. One hundred cases of ectopic acromegaly due to secretion of GHRH have been described. Given the rarity of this pathology, we present a clinical case with the aim of contributing our diagnostic-therapeutic experience and the subsequent follow-up. We present the case of a patient with acromegaloid physical features that had evolved over several years. Concomitantly, he also presented other accompanying symptoms that were suggestive of a possible bronchial origin. Facing the clinical suspicion of acromegaly, we opted to confirm it biochemically and subsequently through image study. A hypophysary origin was ruled out, so we carried out screening for a bronchial neuroendocrine and/or gastrointestinal tumor as they are the most frequent localizations. The treatment of choice was surgical resection.
Assuntos
Acromegalia/etiologia , Neoplasias Brônquicas/complicações , Tumor Carcinoide/complicações , Acromegalia/metabolismo , Adulto , Neoplasias Brônquicas/metabolismo , Tumor Carcinoide/metabolismo , Feminino , Hormônio Liberador de Hormônio do Crescimento/biossíntese , HumanosRESUMO
Los tumores que causan acromegalia ectópica pueden hacerlo a través de la secreción de GH o de GHRH. Se han descrito un centenar de casos de acromegalia ectópica por secreción de GHRH. Dado la rareza de esta patología presentamos un caso clínico con el objetivo de aportar nuestra experiencia diagnóstico-terapéutica y de seguimiento posterior. Se presenta el caso de una paciente con rasgos físicos acromegaloides de varios años de evolución. Deforma concomitante también presentaba otros síntomas acompañantes sugestivos de posible origen bronquial. Ante la sospecha clínica de acromegalia se optó por confirmarlo bioquímicamente y posteriormente mediante estudio de imagen. Se descartó el origen hipofisario por lo que se realizó el despistaje de un tumor neuroendocrino bronquial y/o gastrointestinal por serlas localizaciones más frecuentes. El tratamiento de elección fue la resección quirúrgica (AU)
Tumours that cause ectopic acromegaly can do so through the secretion of GH or GHRH. A hundred cases of ectopic acromegaly due to secretion of GHRH have been described. Given the rarity of this pathology, we present a clinical case with the aim of contributing our diagnostic-therapeutic experience and the subsequent follow-up. We present the case of a patient with acromegaloid physical features that had evolved over several years. Concomitantly, he also presented other accompanying symptoms that suggestive of a possible bronchial origin. Facing the clinical suspicion of acromegaly, we opted to confirm it biochemically and subsequently through image study. A hypophysary origin was ruled out, so we carried out screening for a bronchial neuroendocrine and/or gastrointestinal tumor as they are the most frequent localizations. The treatment of choice was surgical resection (AU)
Assuntos
Humanos , Feminino , Adulto , Acromegalia/etiologia , Tumor Carcinoide/patologia , Neoplasias Brônquicas/complicações , Tumores Neuroendócrinos/complicaçõesAssuntos
Diabetes Mellitus Tipo 2/tratamento farmacológico , Diabetes Mellitus Tipo 2/fisiopatologia , Hiperglicemia/tratamento farmacológico , Hiperglicemia/etiologia , Quimioterapia Combinada , Hemoglobinas Glicadas/análise , Humanos , Hiperglicemia/diagnóstico , Hipoglicemiantes/uso terapêutico , Insulina/uso terapêutico , Metformina/uso terapêuticoRESUMO
No disponible
Assuntos
Humanos , Hiperglicemia/tratamento farmacológico , Diabetes Mellitus Tipo 2/tratamento farmacológico , Hipoglicemiantes/uso terapêutico , Padrões de Prática Médica , Índice Glicêmico , Esquema de Medicação , Hemoglobina A/análise , Metformina/uso terapêutico , Inibidores da Dipeptidil Peptidase IV/uso terapêutico , Tiazolidinedionas/uso terapêutico , Sistemas de Infusão de InsulinaRESUMO
A case is presented of Cushing's syndrome due to macronodular bilateral adrenal hyperplasia which is ACTH-independent as was demonstrated by the undetectable basal and after stimulation with metoprolol ACTH plasma levels. High cortisol levels is associated in this patient with empty sella turcica and anterior panhypopituitarism with confirm the exclusive adrenal origin of the hormone hypersecretion and the lack of treatment success with hypophysis ablation in this process.
Assuntos
Glândulas Suprarrenais/patologia , Hormônio Adrenocorticotrópico/sangue , Síndrome de Cushing/diagnóstico , Síndrome da Sela Vazia/diagnóstico , Hiperpituitarismo/diagnóstico , Idoso , Síndrome de Cushing/sangue , Síndrome da Sela Vazia/sangue , Humanos , Hiperpituitarismo/sangue , Hiperplasia/sangue , Hiperplasia/diagnóstico , Metirapona , Adeno-HipófiseRESUMO
No disponible