Recurrent Pericarditis in a Woman With Acromegaly Responding Favorably to Transsphenoidal Surgery
Objective: Acromegaly is associated with increased insulin-like growth factor 1 (IGF-1), promoting systemic inflammation and cardiovascular complications. We present a patient with acromegaly who developed recurrent pericarditis, resolving soon after somatotroph pituitary adenoma resection. The obje...
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Elsevier
2025-03-01
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| Series: | AACE Clinical Case Reports |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2376060525000045 |
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| author | Samantha Jacobson, MSc Jonathan-Raphaël Stetco Natasha Garfield, MD, FRCPC |
| author_facet | Samantha Jacobson, MSc Jonathan-Raphaël Stetco Natasha Garfield, MD, FRCPC |
| author_sort | Samantha Jacobson, MSc |
| collection | DOAJ |
| description | Objective: Acromegaly is associated with increased insulin-like growth factor 1 (IGF-1), promoting systemic inflammation and cardiovascular complications. We present a patient with acromegaly who developed recurrent pericarditis, resolving soon after somatotroph pituitary adenoma resection. The objective of this report is to describe a case of uncontrolled acromegaly with recurrent, unexplained pericarditis. Case Report: A 46-year-old woman was referred after a neurologist identified a 9 mm pituitary lesion on magnetic resonance imaging. Laboratory tests showed elevated IGF-1 of 52.3 nmol/mL (12.3–32.9 nmol/L), a nonsuppressible growth hormone (GH) level of 3.8 mcg/L (<0.4 mcg/L) after a 75 g oral glucose tolerance test, confirming acromegaly. One-year postdiagnosis, the patient developed pleuritic chest pain from pericarditis with moderate-to-severe pericardial effusion. Symptoms resolved with nonsteroidal antiinflammatory drugs, colchicine and pericardiocentesis. Over 3 years she experienced multiple episodes of recurrent pericarditis. A comprehensive diagnostic workup, including rheumatologic and infectious evaluations, was negative. After transsphenoidal adenoma resection, IGF-1 normalized, and medical therapy was discontinued. Pericarditis recurred 2 months postoperatively but has not occurred again over 12 years of acromegaly remission. Discussion: Hypersecretion of GH in acromegaly leads to elevated IGF-1 levels, which affect inflammatory responses. IGF-1 can promote systemic inflammation through proinflammatory cytokines, its effects may vary depending on tissue type. In this case, resolution of pericarditis following IGF-1 normalization suggests that elevated IGF-1 levels may mediate the inflammatory process in the pericardium. Conclusion: The case suggests that acromegaly may predispose some patients to pericarditis, but its frequency and underlying pathogenesis remain unclear. |
| format | Article |
| id | doaj-art-009b8d19a69149e78a7fc5a7cb9b7c2a |
| institution | Kabale University |
| issn | 2376-0605 |
| language | English |
| publishDate | 2025-03-01 |
| publisher | Elsevier |
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| series | AACE Clinical Case Reports |
| spelling | doaj-art-009b8d19a69149e78a7fc5a7cb9b7c2a2025-08-20T03:42:41ZengElsevierAACE Clinical Case Reports2376-06052025-03-0111215115410.1016/j.aace.2025.01.002Recurrent Pericarditis in a Woman With Acromegaly Responding Favorably to Transsphenoidal SurgerySamantha Jacobson, MSc0Jonathan-Raphaël Stetco1Natasha Garfield, MD, FRCPC2Faculty of Medicine, University of Sherbrooke, Sherbrooke, Quebec, CanadaFaculty of Medicine, University of Sherbrooke, Sherbrooke, Quebec, CanadaDivision of Endocrinology, McGill University Health Centre, Montreal, Quebec, Canada; Address correspondence to Dr Natasha Garfield, Division of Endocrinology and Metabolism, McGill University, McGill University Health Center, 1001, Décarie, Montréal, Quebec H4A 3J1, Canada.Objective: Acromegaly is associated with increased insulin-like growth factor 1 (IGF-1), promoting systemic inflammation and cardiovascular complications. We present a patient with acromegaly who developed recurrent pericarditis, resolving soon after somatotroph pituitary adenoma resection. The objective of this report is to describe a case of uncontrolled acromegaly with recurrent, unexplained pericarditis. Case Report: A 46-year-old woman was referred after a neurologist identified a 9 mm pituitary lesion on magnetic resonance imaging. Laboratory tests showed elevated IGF-1 of 52.3 nmol/mL (12.3–32.9 nmol/L), a nonsuppressible growth hormone (GH) level of 3.8 mcg/L (<0.4 mcg/L) after a 75 g oral glucose tolerance test, confirming acromegaly. One-year postdiagnosis, the patient developed pleuritic chest pain from pericarditis with moderate-to-severe pericardial effusion. Symptoms resolved with nonsteroidal antiinflammatory drugs, colchicine and pericardiocentesis. Over 3 years she experienced multiple episodes of recurrent pericarditis. A comprehensive diagnostic workup, including rheumatologic and infectious evaluations, was negative. After transsphenoidal adenoma resection, IGF-1 normalized, and medical therapy was discontinued. Pericarditis recurred 2 months postoperatively but has not occurred again over 12 years of acromegaly remission. Discussion: Hypersecretion of GH in acromegaly leads to elevated IGF-1 levels, which affect inflammatory responses. IGF-1 can promote systemic inflammation through proinflammatory cytokines, its effects may vary depending on tissue type. In this case, resolution of pericarditis following IGF-1 normalization suggests that elevated IGF-1 levels may mediate the inflammatory process in the pericardium. Conclusion: The case suggests that acromegaly may predispose some patients to pericarditis, but its frequency and underlying pathogenesis remain unclear.http://www.sciencedirect.com/science/article/pii/S2376060525000045acromegalypericarditisgrowth hormoneinsulin-like growth factor-1cardiovascular complications |
| spellingShingle | Samantha Jacobson, MSc Jonathan-Raphaël Stetco Natasha Garfield, MD, FRCPC Recurrent Pericarditis in a Woman With Acromegaly Responding Favorably to Transsphenoidal Surgery AACE Clinical Case Reports acromegaly pericarditis growth hormone insulin-like growth factor-1 cardiovascular complications |
| title | Recurrent Pericarditis in a Woman With Acromegaly Responding Favorably to Transsphenoidal Surgery |
| title_full | Recurrent Pericarditis in a Woman With Acromegaly Responding Favorably to Transsphenoidal Surgery |
| title_fullStr | Recurrent Pericarditis in a Woman With Acromegaly Responding Favorably to Transsphenoidal Surgery |
| title_full_unstemmed | Recurrent Pericarditis in a Woman With Acromegaly Responding Favorably to Transsphenoidal Surgery |
| title_short | Recurrent Pericarditis in a Woman With Acromegaly Responding Favorably to Transsphenoidal Surgery |
| title_sort | recurrent pericarditis in a woman with acromegaly responding favorably to transsphenoidal surgery |
| topic | acromegaly pericarditis growth hormone insulin-like growth factor-1 cardiovascular complications |
| url | http://www.sciencedirect.com/science/article/pii/S2376060525000045 |
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