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Delayed diagnosis of acromegaly in a patient with focal segmental Glomerulosclerosis: a rare case report and literature review
- Source :
- BMC Nephrology, Vol 20, Iss 1, Pp 1-5 (2019), BMC Nephrology
- Publication Year :
- 2019
- Publisher :
- Springer Science and Business Media LLC, 2019.
-
Abstract
- BackgroundExperimental studies have demonstrated that hypersecretion of growth hormone (GH) is associated with development of glomerular sclerosis. However, clinical case of such condition is very rare. Here we presented a case of focal segmental glomerulosclerosis (FSGS) associated with acromegaly.Case presentationA 63-year-old man was diagnosed as nephrotic syndrome with minimal change disease for 2 years. Prednisone 1 mg/kg/day for 9 months led to no response. After admission, the second kidney biopsy indicated FSGS (NOS variant). On admission, his acromegalic features were noticed and he complained with a 20-year history of soft tissue swelling of hands and feet. Serum GH and insulin-like growth factor 1 (IGF-1) concentrations were both elevated significantly. An oral glucose tolerance test showed inadequate suppression of serum GH. The presence of a pituitary macroadenoma with a diameter of 1.4 cm by MRI confirmed the diagnosis of acromegaly. Then, the tumor was subtotally removed by trans-sphenoidal surgery. Partial remission of proteinuria was achieved 3 months after surgery and maintained during follow-up, with gradual reduce of corticosteroid.ConclusionsThis rare case suggested that the hypersecretion of GH may participate, at least in part, in FSGS development and progression. Early diagnosis and treatment of acromegaly is beneficial.
- Subjects :
- Adenoma
Male
medicine.medical_specialty
Nephrotic Syndrome
030232 urology & nephrology
Case Report
Focal segmental glomerulosclerosis
030209 endocrinology & metabolism
Kidney
lcsh:RC870-923
Gastroenterology
Diagnosis, Differential
03 medical and health sciences
0302 clinical medicine
Prednisone
Internal medicine
Acromegaly
Biopsy
medicine
Humans
Pituitary Neoplasms
Minimal change disease
Insulin-Like Growth Factor I
Growth hormone
Hypophysectomy
Proteinuria
medicine.diagnostic_test
Glomerulosclerosis, Focal Segmental
Human Growth Hormone
business.industry
Glomerulosclerosis
Glucose Tolerance Test
Middle Aged
lcsh:Diseases of the genitourinary system. Urology
medicine.disease
Magnetic Resonance Imaging
Pituitary adenoma
Treatment
Treatment Outcome
Nephrology
Pituitary Gland
medicine.symptom
business
Nephrotic syndrome
medicine.drug
Subjects
Details
- ISSN :
- 14712369
- Volume :
- 20
- Database :
- OpenAIRE
- Journal :
- BMC Nephrology
- Accession number :
- edsair.doi.dedup.....94a6f687dfa49a64aed2308dd76cb8cc