Acromegaly accompanied by diabetes mellitus and polycystic kidney disease
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- Otani Daisuke
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan Department of Diabetes and Endocrinology, Shiga General Hospital, Moriyama, Japan
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- Murakami Takaaki
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan Department of Diabetes and Endocrinology, Shiga General Hospital, Moriyama, Japan
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- Matsubara Takeshi
- Department of Nephrology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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- Hojo Masato
- Department of Neurosurgery, Shiga General Hospital, Moriyama, Japan
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- Nakae Takuro
- Department of Neurosurgery, Shiga General Hospital, Moriyama, Japan
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- Moriyoshi Koki
- Department of Diagnostic Pathology, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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- Yasoda Akihiro
- Clinical Research Center, National Hospital Organization Kyoto Medical Center, Kyoto, Japan
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- Usui Ryota
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
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- Tatsuoka Hisato
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
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- Ogura Masahito
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
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- Inagaki Nobuya
- Department of Diabetes, Endocrinology and Nutrition, Kyoto University Graduate School of Medicine, Kyoto, Japan
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- Yamamoto Taizou
- Department of Diabetes and Endocrinology, Shiga General Hospital, Moriyama, Japan
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Abstract
<p>Acromegaly is characterized by autonomous excessive growth hormone (GH) secretion, generally due to GH-producing pituitary adenoma, and is associated with various systemic comorbidities including diabetes mellitus. Polycystic kidney disease (PKD) is characterized by the growth of numerous cysts in the kidneys that deteriorate renal function. While possible renal effects of excessive GH exposure have been a current issue in experimental medicine, only five cases of coexisting acromegaly and PKD have been reported previously, and little is known regarding the influence of acromegaly on renal disease. We treated a 50-year-old male with diabetes mellitus who showed a sudden and rapid decline of renal function along with increasing proteinuria, which led to diagnoses of PKD and acromegaly. His urinary protein levels were increased together with excessive GH secretion and worsening glycemic control. An increase of total kidney volume was also noted. Transsphenoidal surgery for the pituitary adenoma was successfully performed. Marked improvement of hyperglycemia and proteinuria were observed after the surgery, but renal function was unchanged. The patient’s clinical course suggested common aspects of excessive GH secretion as an accelerating factor of the progression of diabetic nephropathy and PKD via direct and indirect pathways. Although coexisting acromegaly and PKD is clinically rare, vigilance for early diagnosis of acromegaly is appropriate in patients with diabetes and/or PKD, especially in those showing unexpected exacerbation of renal dysfunction.</p>
Journal
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- Endocrine Journal
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Endocrine Journal 68 (1), 103-110, 2021
The Japan Endocrine Society
