title: A case of acromegaly accompanied by adrenal preclinical Cushing's syndrome.
abstract: We encountered a 58-year-old woman with acromegaly accompanied by a cortisol-secreting adrenal tumor without clinical features of hypercortisolism. The simultaneous occurrence of these two endocrinopathies in one individual is extremely rare. She was diagnosed as having diabetes mellitus 8 years ago. Afterwards, in spite of insulin therapy, her hyperglycemia could not be well controlled. Her acromegaly and preclinical Cushing's syndrome were histopathologically proven to be due to a pituitary adenoma and an adrenocortical adenoma, respectively. Successful treatment for these endocrinopathies resulted in greatly improved blood sugar control because of a reduction in insulin resistance. In this case of preclinical Cushing's syndrome, replacement therapy with glucocorticoid was able to be discontinued at only 8 weeks after adrenalectomy, so that the period of necessary replacement was much shorter than that for overt Cushing's syndrome. This is the first report describing insulin resistance before and after treatment in a case of acromegaly accompanied by adrenal preclinical Cushing's syndrome.
authors.affiliation: Third Department of Internal Medicine, Hirosaki University School of Medicine, Aomori, Japan.
authors.forename: R
authors.initials: R
authors.lastname: Nasushita
authors.forename: H
authors.initials: H
authors.lastname: Watanobe
authors.forename: T
authors.initials: T
authors.lastname: Goto
authors.forename: Y
authors.initials: Y
authors.lastname: Tando
authors.forename: M
authors.initials: M
authors.lastname: Tanosaki
authors.forename: T
authors.initials: T
authors.lastname: Shiroto
authors.forename: M
authors.initials: M
authors.lastname: Tsujino
authors.forename: N
authors.initials: N
authors.lastname: Horiba
authors.forename: T
authors.initials: T
authors.lastname: Suzuki
authors.forename: S
authors.initials: S
authors.lastname: Suzuki
authors.forename: T
authors.initials: T
authors.lastname: Suda
mesh_terms: D000172:Acromegaly / Q000150:complications / Q000175:diagnosis*; D000236:Adenoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D000306:Adrenal Cortex Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D001786:Blood Glucose / Q000378:metabolism; D003480:Cushing Syndrome / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000097:blood / Q000188:drug therapy; D005260:Female; D015309:Glucose Clamp Technique; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism; D007333:Insulin Resistance; D008279:Magnetic Resonance Imaging; D008875:Middle Aged; D010911:Pituitary Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D014057:Tomography, X-Ray Computed
chemical_list: D001786:Blood Glucose; D006854:Hydrocortisone