Endocrinol Metab.  2012 Dec;27(4):318-322. 10.3803/EnM.2012.27.4.318.

A Case of Latent Autoimmune Diabetes in Adults Developed after Surgical Cure of Growth Hormone Secreting Pituitary Tumor

• Kim W
• Kim JH
• Kim Y
• Huh JH
• Lee SJ
• Park MS
• Choe EY
• Park JK
• Lee MW
• Hong JW
• Lee BW
• Kang ES
• Cha BS
• Lee EJ
• Lee HC

• KMID: 1973797
• DOI: http://doi.org/10.3803/EnM.2012.27.4.318

Abstract

Acromegaly is generally caused by a benign growth hormone (GH)-secreting pituitary adenoma. It is characterized by a wide range of complications; cardiovascular, respiratory, bone and joint, and metabolic complications. Among them, impaired glucose tolerance and diabetes mellitus, due to GH-induced insulin resistance, has been reported in approximately 16-46% and 19-56%. They are usually improved following the treatment of acromegaly, surgical or medical therapy. We report a first case of 36-year-old man who was paradoxically diagnosed with GAD antibody positive latent autoimmune diabetes in adults (LADA) after the surgical cure of acromegaly.

Keyword

Acromegaly; Type 2 diabetes mellitus

MeSH Terms

Acromegaly
Adult
Diabetes Mellitus
Diabetes Mellitus, Type 1
Diabetes Mellitus, Type 2
Glucose
Growth Hormone
Humans
Insulin Resistance
Joints
Pituitary Neoplasms
Glucose
Growth Hormone

Figure

• 

  Fig. 1 A 75 g oral glucose tolerance tests (pre- and post-operation). (A) A 75 g oral glucose tolerance test for serum glucose levels; This patient was confirmed acromegaly with insulin-independent diabetes mellitus. It is cured after tumor resection. (B) A 75 g oral glucose tolerance test for growth hormone as a confirmation test for acromegaly remission. There was excessive secretion of growth hormone (GH) which was decreased after tumor resection (GH normal range, 0-9.5 ng/mL).

• 

  Fig. 2 Sella magnetic resonance imaging and dynamic. (A) Pre-operation (November 25, 2009). (B) One year after operation (March 9, 2011).

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