Manifestation of Rheumatoid Arthritis after Transsphenoidal Surgery in a Patient with Acromegaly

Endocrine Journal

Tomoko MIYOSHI¹  Toshio OGURA¹  Tetsuro SEI²  Masanori KAWASHIMA¹  Masahiro YAMAMURA¹  Hirofumi MAKINO¹  Kenichi INAGAKI¹  Fumio OTSUKA¹  Tomoko KAWABATA¹  Tomoyuki MUKAI¹ 

[1] Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences;Department of Radiology, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences

关键词: Acromegaly;    Arthropathy;    Growth hormone;    Pituitary adenoma;    Rheumatoid arthritis;   

DOI  :  10.1507/endocrj.K06-043

学科分类：内分泌与代谢学

来源: Japan Endocrine Society

【 摘 要 】

References(21)Cited-By(2)Acromegalic arthropathy is one of the most frequent manifestations occurring in acromegaly patients. In contrast, rheumatoid arthritis (RA) is a rare clinical complication in acromegaly patients. Here, we report a 70-year-old Japanese woman with acromegaly, who complained of bilateral finger stiffness and polyarthralgia two months after transsphenoidal surgery of a growth hormone (GH)-secreting pituitary adenoma. Postoperative levels of serum GH and insulin-like growth factor-1 (IGF-1) were markedly decreased without any secretory deficiency of other anterior pituitary hormones. Hand X-ray did not show typical RA changes; however, erosive changes in carpal bones were clearly detected by magnetic resonance imaging with gadolinium enhancement. Based on the levels of serological markers in the patient following surgery including C-reactive protein, rheumatoid factor and matrix metalloproteinase-3, anti-rheumatic therapy was subsequently commenced. Regardless of the levels of GH and IGF-1, acromegaly patients frequently complain about joint-related symptoms even after remission. Therefore, careful observation of bone erosive changes and immunological activity in acromegaly patients is required when joint-related symptoms persist.

【 授权许可】

Unknown