A Case of Nonalcoholic Steatohepatitis in a Cured Acromegalic Patient With Severe Growth Hormone Deficiency

Satoshi Yamagata, MD, PhD; Kazunori Kageyama, MD, PhD; Shingo Murasawa, MD, PhD; Ken Tomotsune, MD, PhD; Shoko Kawashima, MD, PhD; Koshi Makita, MD; Yoichi Yamamoto, MD; Koji Shimaya, MD, PhD; Hiroshi Numao, MD, PhD; Yasuaki Tazawa, MD, PhD; Yoshiji Ogawa, MD, PhD

AACE Clinical Case Reports (Jan 2016)

A Case of Nonalcoholic Steatohepatitis in a Cured Acromegalic Patient With Severe Growth Hormone Deficiency

Satoshi Yamagata, MD, PhD,
Kazunori Kageyama, MD, PhD,
Shingo Murasawa, MD, PhD,
Ken Tomotsune, MD, PhD,
Shoko Kawashima, MD, PhD,
Koshi Makita, MD,
Yoichi Yamamoto, MD,
Koji Shimaya, MD, PhD,
Hiroshi Numao, MD, PhD,
Yasuaki Tazawa, MD, PhD,
Yoshiji Ogawa, MD, PhD

Affiliations

Satoshi Yamagata, MD, PhD: Diabetes Center, Department of Endocrinology, Aomori Prefectural Central Hospital, Aomori, Japan; Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Aomori, Japan; Address correspondence to Dr. Satoshi Yamagata, Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, 5 Zaifu-cho, Hirosaki, Aomori 036-8562, Japan.
Kazunori Kageyama, MD, PhD: Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Aomori, Japan
Shingo Murasawa, MD, PhD: Diabetes Center, Department of Endocrinology, Aomori Prefectural Central Hospital, Aomori, Japan; Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Aomori, Japan
Ken Tomotsune, MD, PhD: Diabetes Center, Department of Endocrinology, Aomori Prefectural Central Hospital, Aomori, Japan
Shoko Kawashima, MD, PhD: Diabetes Center, Department of Endocrinology, Aomori Prefectural Central Hospital, Aomori, Japan
Koshi Makita, MD: Department of Endocrinology and Metabolism, Hirosaki University Graduate School of Medicine, Aomori, Japan
Yoichi Yamamoto, MD: Department of Gastroenterology, Aomori Prefectural Central Hospital, Aomori, Japan.
Koji Shimaya, MD, PhD: Department of Gastroenterology, Aomori Prefectural Central Hospital, Aomori, Japan.
Hiroshi Numao, MD, PhD: Department of Gastroenterology, Aomori Prefectural Central Hospital, Aomori, Japan.
Yasuaki Tazawa, MD, PhD: Diabetes Center, Department of Endocrinology, Aomori Prefectural Central Hospital, Aomori, Japan
Yoshiji Ogawa, MD, PhD: Diabetes Center, Department of Endocrinology, Aomori Prefectural Central Hospital, Aomori, Japan

Journal volume & issue: Vol. 2, no. 3
pp. e194 – e198

Abstract

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ABSTRACT: Objective: Acromegaly is associated with metabolic and neoplastic complications, but successful treatment of acromegaly can sometimes result in growth hormone deficiency (GHD). Nonalcoholic fatty liver disease may develop in GHD, although there are few reports of such cases after cured acromegaly.Methods: We report the case of a 41-year-old woman with nonalcoholic steatohepatitis associated with GHD after surgical cure of acromegaly.Results: Growth hormone (GH) replacement therapy improved serum triglyceride, hyaluronic acid, and type IV collagen levels as well as liver function and quality of life. Computed tomography (CT) showed reduced volumes of both visceral and subcutaneous fat and an increased liver/spleen CT attenuation value.Conclusion: Cured acromegalic patients should be carefully examined if GHD and associated metabolic disorders arise. Appropriate diagnosis of GHD and prompt treatment with GH replacement should ameliorate liver dysfunction and the metabolic changes associated with GHD.Abbreviations: ALT = alanine aminotransferase AST = aspartate aminotransferase BMI = body mass index CT = computed tomography GH = growth hormone GHD = growth hormone deficiency HbA1c = glycated hemoglobin IGF-1 = insulin-like growth factor 1 NAFLD = nonalcoholic fatty liver disease NASH = nonalcoholic steatohepatitis OGTT = oral glucose tolerance test rhGH = recombinant human GH

Published in AACE Clinical Case Reports

ISSN: 2376-0605 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the endocrine glands. Clinical endocrinology
Website: https://www.journals.elsevier.com/aace-clinical-case-reports

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