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