Acromegaly with joint pain as an initial symptom: A case report

Int J Rheum Dis. 2023 Jun;26(6):1129-1133. doi: 10.1111/1756-185X.14572. Epub 2023 Jan 17.

Abstract

Background: Acromegaly is caused by the long-term excessive secretion of growth hormone (GH) and insulin-like growth factor-1 (IGF-1). It can cause excessive hyperplasia of bone, cartilage, and soft tissue.

Case presentation: A 50-year-old woman had a history of joint pain and swelling for more than 1 year. She visited a local primary care clinic, but her illness was not diagnosed by a primary care physician. After relevant examination in our hospital, we excluded inflammatory arthritis such as rheumatoid arthritis, immune disease-related arthritis, and infectious arthritis, and considered osteoarthritis or endocrine-metabolic arthritis. When we examined her again, we found that her fingers and toes were enlarged. She was diagnosed with acromegaly after IGF-1 test, and pituitary magnetic resonance imaging. Her joint symptoms were significantly relieved and her prognosis was good after surgery in another hospital.

Conclusions: Acromegaly is a complex and rare disease, which is difficult to diagnose. When a patient presents with arthralgia, it is easily misdiagnosed as a rheumatic disease, and the diagnosis and treatment are delayed.

Keywords: acromegaly; case report; diagnosis; joint pain.

Publication types

  • Case Reports

MeSH terms

  • Acromegaly* / diagnosis
  • Acromegaly* / etiology
  • Acromegaly* / surgery
  • Arthralgia / complications
  • Arthritis, Rheumatoid* / diagnosis
  • Female
  • Human Growth Hormone*
  • Humans
  • Insulin-Like Growth Factor I
  • Middle Aged
  • Pituitary Neoplasms*

Substances

  • Insulin-Like Growth Factor I
  • Human Growth Hormone