Pituitary gigantism: a case series from Hospital de San José (Bogotá, Colombia)
Introduction: Gigantism is a rare pediatric disease characterized by increased production of growth hormone (GH) before epiphyseal closure, that manifests clinically as tall stature, musculoskeletal abnormalities, and multiple comorbidities. Materials and methods: Case series of 6 male patients with...
| Autores: | , , |
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| Tipo de documento: | artigo |
| Estado: | Versão publicada |
| Data de publicação: | 2019 |
| País: | Colombia |
| Recursos: | Fundación Universitaria de Ciencias de la Salud - FUCS |
| Repositório: | Repositorio Digital Institucional ReDi |
| Idioma: | inglês |
| OAI Identifier: | oai:repositorio.fucsalud.edu.co:001/2596 |
| Acesso em linha: | https://repositorio.fucsalud.edu.co/handle/001/2596 |
| Access Level: | Acceso aberto |
| Palavra-chave: | Pituitary diseases Pituitary neoplasms Growth hormone Gigantism Acromegaly Acromegalia Gigantismo Hormona del crecimiento Neoplasias hipofisárias Enfermedades de la hipófisis |
| Resumo: | Introduction: Gigantism is a rare pediatric disease characterized by increased production of growth hormone (GH) before epiphyseal closure, that manifests clinically as tall stature, musculoskeletal abnormalities, and multiple comorbidities. Materials and methods: Case series of 6 male patients with gigantism evaluated at the Endocrinology Service of Hospital de San José (Bogotá, Colombia) between 2010 and 2016. Results: All patients had macroadenomas and their mean final height was 2.01 m. The mean age at diagnosis was 16 years, and the most common symptoms were headache (66%) and hyperhidrosis (66%). All patients had acral changes, and one had visual impairment secondary to compression of the optic chiasm. All patients underwent surgery, and 5 (83%) required additional therapy for biochemical control, including radiotherapy (n = 4, 66%), somatostatin analogues (n = 5, 83%), cabergoline (n = 3, 50%), and pegvisomant (n = 2, 33%). Three patients (50%) achieved complete biochemical control, while 2 patients showed IGF-1 normalization with pegvisomant. Two patients were genetically related and presented a mutation in the aryl hydrocarbon receptor-interacting protein (AIP) gene (pathogenic variant, c.504G>A in exon 4, p.Trp168*), fulfilling the diagnostic criteria of familial isolated pituitary adenoma. Conclusions: This is the largest case series of patients with gigantism described to date in Colombia. Transsphenoidal surgery was the first-choice procedure, but additional pharmacological therapy was usually required. Mutations in the AIP gene should be considered in familial cases of GH-producing adenomas |
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