A Case of Acromegaly Accompanied by Adrenal Preclinica Cushing's Syndrome

RYO NASUSHITA; HAJIME WATANOBE; TAKASHI GOTO; YUSUKE TANDO; MASATO TANOSAKI; TASUKU SHIROTO; MORIYASU TSUJINO; NOBUO HORIBA; TADASHI SUZUKI; SHIGEHARU SUZUKI; TOSHIHIRO SUDA

doi:10.1507/endocrj.46.133

RYO NASUSHITA, HAJIME WATANOBE, TAKASHI GOTO, YUSUKE TANDO, MASATO TANOSAKI, TASUKU SHIROTO, MORIYASU TSUJINO, NOBUO HORIBA, TADASHI SUZUKI, SHIGEHARU SUZUKI, TOSHIHIRO SUDA

Author information

RYO NASUSHITA
Third Department of Internal Medicine, Hirosaki University School of Medicine
HAJIME WATANOBE
Third Department of Internal Medicine, Hirosaki University School of Medicine
TAKASHI GOTO
Third Department of Internal Medicine, Hirosaki University School of Medicine
YUSUKE TANDO
Third Department of Internal Medicine, Hirosaki University School of Medicine
MASATO TANOSAKI
Third Department of Internal Medicine, Hirosaki University School of Medicine
TASUKU SHIROTO
Third Department of Internal Medicine, Hirosaki University School of Medicine
MORIYASU TSUJINO
Third Department of Internal Medicine, Hirosaki University School of Medicine
NOBUO HORIBA
Third Department of Internal Medicine, Hirosaki University School of Medicine
TADASHI SUZUKI
Department of Urology, Hirosaki University School of Medicine
SHIGEHARU SUZUKI
Department of Brain-Surgery, Hirosaki University School of Medicine
TOSHIHIRO SUDA
Third Department of Internal Medicine, Hirosaki University School of Medicine

Keywords: Acromegaly, Preclinical Cushing's syndrome, Insulin resistance, Euglycemic hyperinsulinemic clamp technique

JOURNAL FREE ACCESS

1999 Volume 46 Issue 1 Pages 133-137

DOI https://doi.org/10.1507/endocrj.46.133

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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.

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