Old Wine in a New Bottle: Acromegaly Presenting as Diabetic Ketoacidosis

Abstract

Acromegaly is a rare disease characterised by chronic excess of Growth Hormone (GH) levels. Insulin signalling is impaired, gluconeogenesis is excess and peripheral insulin resistance is increased in acromegaly causing hyperglycaemia and diabetes. Diabetic Ketoacidosis (DKA) is a rare but known complication of diabetes in acromegaly. Most cases of acromegaly come into light due to the classical soft tissue changes in the face and extremities. A high index of suspicion is required to diagnose this condition in early stage. Here, a case of 22-years-old male presented with DKA and on investigation was found to have acromegaly due to a GH secreting pituitary macroadenoma. This management and subsequent follow-up of the case along with review of literature is also done. Such a presentation of acromegaly was rare but rewarding.

Keywords

• growth hormone excess
• ketosis
• pituitary macroadenoma