A case of acromegaly in the presence of coincidental liver cirrhosis

Abstract

Context: Acromegaly is a rare and serious syndrome and commonly associated with pituitary neoplasm. Classic cause of acromegaly in adults is the tumors of the somatotrophs that secrete growth hormone. Cirrhosis is the end stage of chronic liver disease and commonly a cause of death. It is characterized by diffuse hepatic fibrosis resulting in altered construction of the lobular parenchyma with widespread connective tissue scptae, circumscribed regenerative nodules of hepatocytcs and anastomoses between vascular channels linking portal and central vessels. Objective: To report the simultaneous cases of acromegaly and cirrhosis. Case report: A 62-year old, male patient came to the hospital complaining of severe abdominal swelling. Laboratory and imaging findings were compatible with the presence of hepatitis B virus related cirrhosis together with acromegaly. In this case, he had high GH level but lower IGF-1 level because of hepatic failure which can impair IGF-1 production by the liver. Definitive diagnosis was made by pituitary MR and a 1 cm in diameter tumor was detected. Conclusion: This paper showed that cirrhosis can result in a low IGF-I level in patients with acromegaly. There is no previous report available of the in the presence of coincidental combination of acromegaly and cirrhosis in a patient.