Hipofizer Gigantizm: Olgu Sunumu

Hipofizer gigantizm (hipofizer devlik), epifizyal plaklar kapanmadan önce hipofizden fazla miktarda büyüme hormonu (BH) salgılanmasına bağlı olarak gelişir. Nadir bir endokrinolojik hastalık olmasına rağmen her yaş çocukta görülebilir. Artmış serum BH ve insülin benzeri büyüme faktörü-I (IGF-I) hızlı ve aşırı bir boy uzamasına yol açar. Tanı ve tedavide gecikme, oldukça uzun bir erişkin boyla sonuçlanır. Kliniğimize kilo fazlalığı şikayeti ile başvuran 13,5 yaşındaki kız hastanın boyunun uzun ve babasının boyuna yakın olması, burun kökünün geniş ve yüz hatlarının belirgin olması gigantizm açısından şüphe uyandırdı. Hastanın bakılan bazal serum BH düzeyi 10,4 ng/ml, IGF-I düzeyi 1132 ng/ml olarak ölçüldü. Oral glukoz tolerans testinde serum BH düzeyi baskılanmadı. Hipofiz bezinin manyetik rezonans görüntülemesinde 12 mm boyutunda makroadenom tespit edildi. Hastaya klinik, laboratuvar ve görüntüleme bulgularıyla hipofizer gigantizm tanısı konuldu. Bu yazıda kilo fazlalığı şikayeti ile çocuk endokrin polikliniğine başvuran, klinik şüphe üzerine yapılan ileri incelemesinde hipofizer gigantizm tanısı konulan bir olgu sunulmuştur.

Pituitary Gigantism: A Case Report

Pituitary gigantism occurs as a result of excessive growth hormone secretion before the fusion of epiphyseal growth plates. It is a rare disorder but may occur at any age. Elevated levels of growth hormone (GH) and insulin like growth factor-I (IGF-I) causes rapid and excessive linear growth. Delay in the diagnosis or treatment of the disease results in extremely tall adult stature. A 13.5 year-old girl who presented to our clinic with the complaint of being overweight aroused the suspicion of pituitary gigantism because of her considerably tall stature which was close to the height of her father. Her random GH level was 10.4 ng/ml and IGF-I level 1132 ng/ml. Growth hormone level was not suppressed in oral glucose tolerance test. Magnetic resonans imaging of the brain revealed a 12-mm-sized pituitary adenoma. The patient was diagnosed with pituitary gigantism upon her clinical, laboratory and imaging findings. Herein, we presented a female case who was admitted to our pediatric endocrinology clinic with the complaint of being overweight and was diagnosed with pituitary gigantism on clinical suspicion.

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