title: Acromegaly associated with monoclonal gammopathy of undetermined significance (MGUS).
abstract: Here we report the case of a 65-year-old woman with acromegaly complicated with monoclonal gammopathy of undetermined significance (MGUS). The patient visited Shimane University Hospital for treatment of spinal canal stenosis, and was diagnosed as acromegaly with GH 43.1 ng/ml, insulin-like growth factor (IGF)-I 510 ng/ml and the detection of a pituitary adenoma by MRI. She was also diagnosed as MGUS with IgG 2208 mg/dl, the existence of IgG-kappa type monoclonal protein, and 5.6% plasma cells in bone marrow. After a pituitary adenoma was operatively removed by transsphenoidal approach, IgG levels, as well as GH and IGF-I levels, decreased spontaneously and simultaneously. We suspect a pathogenetic link between acromegaly and MGUS in this case, because both GH and IGF-I are known to directly promote immunoglobulin production from plasma cells, thus inducing the proliferation of the cells in vitro.
authors.affiliation: Department of Endocrinology/Metabolism and Hematology/Oncology, Shimane University Faculty of Medicine, Shimane, Japan.
authors.forename: Ippei
authors.initials: I
authors.lastname: Kanazawa
authors.forename: Toru
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Yuko
authors.initials: Y
authors.lastname: Yamane
authors.forename: Norio
authors.initials: N
authors.lastname: Murakami
authors.forename: Yuzuru
authors.initials: Y
authors.lastname: Kato
authors.forename: Toshitsugu
authors.initials: T
authors.lastname: Sugimoto
mesh_terms: D000172:Acromegaly / Q000097:blood / Q000150:complications* / Q000601:surgery; D000236:Adenoma / Q000097:blood / Q000601:surgery; D000368:Aged; D005260:Female; D019382:Human Growth Hormone / Q000097:blood; D006801:Humans; D007074:Immunoglobulin G / Q000097:blood / Q000652:urine; D007334:Insulin-Like Growth Factor I / Q000032:analysis; D008998:Monoclonal Gammopathy of Undetermined Significance / Q000097:blood / Q000150:complications* / Q000652:urine; D010911:Pituitary Neoplasms / Q000097:blood / Q000601:surgery
chemical_list: D007074:Immunoglobulin G; D019382:Human Growth Hormone; D007334:Insulin-Like Growth Factor I