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 147,016 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

This report deals with a detailed course of one patient with acromegaly who had a pituitary apoplexy. The pituitary apoplexy occurred suddenly 5 days after administration of a oral hypoglycemic agent, buformin, during hospitalization. Immediately after the attack changes of the concentrations of several hormones such as serum growth-hormone, serum thyroid hormone and urinary 17-hydroxycorticosteroids were followed until the development to hypopituitary state. Simultaneously with the decrease of the concentrations of the above-mentioned hormones, a regression of the physical manifestations of acromegaly and a complete amelioration of diabetes mellitus were observed.
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PMID:A case of acromegaly improved by pituitary apoplexy. 16 61

Determination of the indices of central hemodynamics by means of radiocardiography shows them to be essentially changed in patients with acromegaly in the active stage. A clear correlative relationship has been established between the shifts in hemodynamics and the heart volume determined by X-ray. The diagnosis of preclinical stage of circulatory insufficiency is based on revealing a statistically significant increase in the stroke index and a decrease in the circulation volume and total peripheral resistance. In the early stage of acromegaly there is a statistically significant increase in the minute and stroke indices, in the index of minute work, and in the coefficient of circulation effectiveness. With an increase in the duration of the disease, these indices decrease considerably, which denotes hemodynamics deterioration.
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PMID:[Study of hemodynamics in patients with acromegaly by means of radiocardiography]. 35 54

Pituitary function was studied in nine patients who had recovered from pituitary apoplexy. All the patients recovered spontaneously; none required immediate surgery. Four of the patients had acromegaly, two had pituitary-dependent Cushing's syndrome, and a "functionless" pituitary adenoma was found in three. Low serum growth hormone concentrations were observed in three patients with acromegaly whereas the concentration remained increased in the fourth one. Of the two patients with Cushing's syndrome, a selective ACTH-deficiency developed in one and Nelson's syndrome appeared with excessive secretion of ACTH in the other. Transient or persistent hypofunction of the anterior pituitary occurred in al patients. Three patients underwent hypophysectomy after respective intervals of three, eight and 12 months after pituitary apoplex. The operation revealed a hemorrhage in one functionless adenoma and a large cyst in another one. In the third patient who had acromegaly, no signs of the pituitary apoplexy were observed at operation.
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PMID:Pituitary function after pituitary apoplexy. 70 35

A case of acromegaly complicated by pituitary apoplexy is described. The pituitary apoplexy occurred while the patient was under investigation in a metabolic ward permitting full assessment of pituitary function both before and immediately after the event. This demonstrated a remarkably selective reduction in the plasma growth hormone concentration with preservation of other pituitary function excluding mild diabetes insipidus. The plasma growth hormone fell from values greater than 120 ng/ml to less than 4 ng/ml. The brisk inappropriate release of growth hormone observed on stimulation with thyrotrophic hormone releasing hormone, associated with a severe headache and the onset of pituitary apoplexy two days later raised the possibility of provocative tests of pituitary function precipitating pituitary apoplexy.
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PMID:Regression of acromegaly following pituitary apoplexy. 105 79

In 20 patients with acromegaly, morphology of the heart and its systolic and diastolic function were studied by echocardiography, and growth hormone concentration was examined in the serum. Increased muscle mass of the left ventricle was found and that increase depended on disease duration and the growth hormone serum concentration. An increase was also shown of the left ventricular end-diastolic dimension, and the dimensions of left ventricle posterior wall and intraventricular septum, as well as an increase of end-systolic left ventricular dimension and of the size of the left atrium. Out of systolic function parameters, an increase was shown of stroke volume, cardiac output and cardiac index. In 40% of the studied patients an impairment was shown of left ventricular diastolic function but in a half of them no diseases other than acromegaly were found which could have been its cause.
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PMID:[Echocardiographic evaluation of the size and systolic and diastolic function of heart muscle i patients with acromegaly]. 134 28

To investigate cardiovascular changes in experimental acromegaly, a growth hormone-secreting tumour (MtT-W-15) was implanted in adult female rats. Somatic and tumour growth occurred steadily during the 8 week study period, as did an increase in serum growth hormone titre. Weight of left ventricle and right ventricle increased directly with tumour growth, both on an absolute basis and when compared with normal rats of equal body weight. Atrial weight also increased substantially. Haematocrit declined sharply at first, and more slowly later with increasing tumour weight. Haemodynamic measurements were made on these animals at two stages of tumour growth using an anaesthetised open-chest preparation. Cardiac index (per g body wt), stroke index, stroke work, left ventricle +dP/dtmax, and dF/dtmax of aortic flow were greatly elevated in rats with the largest tumours (longer duration), and to a lesser extent in those with smaller tumours (shorter duration). Systemic peripheral resistance and heart rate were depressed. Ventricular weight increased non-linearly with increases in cardiac index. Cardiac output, stroke volume, stroke work and dF/dtmax normalised per g left ventricle weight were also elevated. Splenomegaly accompanied tumour growth; however, splenectomy of tumour-bearing animals failed to prevent development of anaemia and cardiomegaly. While a direct effect of elevated growth hormone provides the best explanation for development of cardiomegaly in this model, volume work overloading due to anaemia and water retention may be a contributory cause.
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PMID:Cardiomegaly and haemodynamics in rats with a transplantable growth hormone-secreting tumour. 315 90

Postoperative persistence of elevated growth hormone (GH) levels in patients with acromegaly usually suggests residual adenoma tissue secreting GH and is an indication for further treatment. In rare cases, spontaneous normalization of serum GH levels in patients with acromegaly has been reported to occur as a consequence of intratumoral hemorrhage (pituitary apoplexy). We report two patients in whom persisting acromegaly was documented 1 and 2 weeks, respectively, after transsphenoidal operation and who experienced spontaneous normalization of GH levels. In one patient, this favorable outcome was found 1.5 years after the operation and followed a pregnancy. The other patient, whose GH values normalized 3 months after operation, had received preoperative treatment with a new, long-acting somatostatin analog.
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PMID:Spontaneous postoperative normalization of growth hormone levels in two patients with acromegaly not cured by transsphenoidal surgery. 320 Mar 94

A 34-year-old man with acromegaly was observed, and the clinical course and various endocrinological deficiencies occurring before, during and after the development of pituitary apoplexy were evaluated. Following the attack, the patient experienced acute reductions in growth hormone (GH) and other pituitary hormones, adrenohypophyseal insufficiency and transient diabetes insipidus which appeared subsequent to glucocorticoid therapy. The level of growth hormone in serum and cerebrospinal fluid (CSF) was measured synchronously, and the respective regressions of GH levels in serum and CSF were observed. The results demonstrated the utility of measuring hormonal levels in CSF in the clinical evaluation of pituitary apoplexy in a patient with a functioning pituitary tumor.
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PMID:Spontaneous remission of acromegaly after pituitary apoplexy following head trauma. 320 21

This report describes the clinical course of pituitary apoplexy induced by a single dose of bromocriptine in a 50-year-old woman with acromegaly. The patient suddenly complained of diminished vision and headache 2 hours after the oral administration of 2.5 mg of bromocriptine. Her visual symptoms and headache persisted for several days. The basal plasma GH concentration decreased from 76.2 ng/ml to 37.2 ng/ml the day after the attack of apoplexy and to 3.0 ng/ml on the 9th day. The authors assess the changes in endocrine findings related to pituitary apoplexy and also emphasize the necessity to view with caution any symptomatic change during bromocriptine therapy.
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PMID:Pituitary apoplexy manifested during a bromocriptine test in a patient with a growth hormone- and prolactin-producing pituitary adenoma. 322 23

Cardiac function was studied by echocardiography in 12 patients with active acromegaly and in 12 age- and sex-matched healthy control subjects. None of the patients had cardiovascular diseases or other endocrine diseases than acromegaly. The patients had a mean age of 39 +/- 5 years and were short-term acromegalic with a mean duration of disease of 6 +/- 3 years. Mean left ventricular mass was 163 +/- 43 g/m2 in the acromegalic group versus 120 +/- 24 g/m2 in the control group. Preload (the diastolic diameter of the left ventricle) was within normal limits, while afterload (end-systolic meridional wall stress) was significantly decreased in the acromegalic group. Myocardial contractility assessed as fractional shortening of the left ventricle was 39.9 +/- 3.6% in the acromegalic group versus 32.9 +/- 5.1% in the control group, and cardiac output was increased by 52% in the acromegalic group because of increased heart rate and stroke volume. We suggest that augmented peripheral blood flow is responsible for the condition of cardiac hyperkinesia in short-term acromegaly and involved in the development of hypertension, which is a frequent complication of long-term acromegaly.
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PMID:A hyperkinetic heart in uncomplicated active acromegaly. Explanation of hypertension in acromegalic patients? 336 14


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