Domino effect of pituitary growth hormone tumor complicated by diabetic ketoacidosis and pituitary apoplexy: a case report.
3 Department of Emergency Medicine, Zhejiang Provincial People
The data used to support the findings of this study are included within the article.
Patients with growth hormone (GH) -secreting adenoma usually develop glucose intolerance. GH increases metabolic rate and, when secreted aberrantly, may result in metabolic syndrome. Herein, we examine the associations of pituitary tumor-induced secretion of hormone with insulin resistance and metabolic syndrome, and determine the relation of pituitary tumor apoplexy-induced diabetic ketoacidosis (DKA) and acute pancreatitis.
A 44-year-old male with a history of hypertension presented to the emergency department of our hospital on February 14, 2019 with symptoms of headache, dizziness, and vomiting. Computed tomography of Обзор Sony A58, the head revealed pituitary tumor with bleeding. An ultrasound scan of the abdomen revealed fatty liver and acute pancreatitis. Further examination revealed the presence of DKA, hypertriglyceridemia, cortical hypofunction crisis and acute kidney injury.
Surgical endoscopic resection of the pituitary tumor resection via the transsphenoidal approach was performed. The patient
Long-term growth hormone abnormality may trigger insulin resistance, leading to metabolic syndrome and impaired glucose and lipid metabolism. The pituitary adenoma apoplexy may also directly induce DKA, creating a domino effect, which further deteriorate the aberrant metabolism of glucose and lipids.
The online version contains supplementary material available at 10.1186 / s12902-021-00768-9.
Patients with growth hormone-secreting adenoma usually develop glucose intolerance . Growth hormone (GH) also increases the rate of lipid metabolism, resulting in elevated production of ketone bodies. Coexistence of impaired glucose metabolism, hyperinsulinemia, hypertriglyceridemia (HTG), and hypertension is characteristic of metabolic syndrome (MetS), a cluster of five individual risk factors, including hyperglycemia, hypertriglyceridemia, hypertension, abnormal lipid metabolism and abdominal obesity .
Although the precise etiology of MetS remains unclear, insulin resistance is a key causative factor, the result of excess circulating fatty acids . HTG may result in acute pancreatitis (AP), which has a global incidence rate of 15