title: A case of acromegaly complicated with diabetic ketoacidosis, pituitary apoplexy, and lymphoma.
abstract: Acromegaly is always complicated with comorbidities and increased mortality. The disease activity and mortality outcomes are highly correlated to the level of growth hormone and insulin-like growth factor 1. A variety of clinical manifestations of acromegaly have been reported. We present a unique case where a 49-year-old male was diagnosed with acromegaly with a first manifestation as an episode of diabetic ketoacidosis. Because he refused any suggestion of treatment, a recurrent episode of diabetic ketoacidosis with pituitary apoplexy occurred. A huge B-cell lymphoma displaying as a huge facial mass followed within 1 year of the diagnosis of acromegaly. Death from advanced cancer ensued 3 years later. This clinical experience strongly reinforces the urgency of controlling growth hormone and insulin-like growth factor 1 as soon as possible once acromegaly is diagnosed.
authors.affiliation: Division of Endocrinology and Metabolism, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: He-Jiun
authors.initials: HJ
authors.lastname: Jiang
authors.forename: Wei-Wen
authors.initials: WW
authors.lastname: Hung
authors.forename: Pi-Jung
authors.initials: PJ
authors.lastname: Hsiao
mesh_terms: D000172:Acromegaly / Q000150:complications / Q000175:diagnosis*; D016883:Diabetic Ketoacidosis / Q000150:complications*; D006801:Humans; D008223:Lymphoma / Q000150:complications*; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D010899:Pituitary Apoplexy / Q000150:complications*; D014057:Tomography, X-Ray Computed
keywords: Acromegaly; Diabetic ketoacidosis; Lymphoma; Pituitary apoplexy