Complete remission of acromegaly with medical treatment
R. F. Spark, G. Dickstein and J. Pallotta
A 40-year-old patient with a ten-year history of acromegaly had persistent
disease despite prior treatment with conventional pituitary radiotherapy
and two transsphenoidal hypophysectomies. Initial evaluation showed
characteristic acromegalic features, hypertension, amenorrhea,
inappropriate diaphoresis, and poorly controlled diabetes mellitus despite
isophane insulin suspension daily. Growth-hormone levels were high and did
not suppress with glucose load. Treatment with bromocriptine was associated
with prompt improvement in glucose intolerance, with elimination of insulin
requirement within 72 hours of institutions of this therapy. Blood pressure
normalized; inappropriate diaphoresis disappeared. Within three months
ovulatory menses were noted to resume for the first time in ten years.
There was progressive improvement in the soft-tissue changes of acromegaly.
The growth-hormone levels fell within three hours after the first dose of
bromocryptine and remained suppressed throughout her six-month course of
therapy.
