Subject(s)
Humans , Female , Diabetes Mellitus, Type 1 , Hypokalemia/diagnosis , Bartter Syndrome , Potassium Chloride , SpironolactoneABSTRACT
The occurrence of acromegaly before the end of the growth period is very rare. We report a case of a patient who presented an acromegalo-gigantism. His height reached 2.45 m and his weight 145 kg. He had a typical facial dysmorphy and an insulin requiring diabetes mellitus. There was no sign of cardio-respiratory failure or of endocrine deficiencies. The echocardiography showed that the left ventricule was moderately dilated and hypertrophied but the systolic function was preserved. Hormonal investigation revealed high growth hormone [GH] levels without suppression after oral glucose load. Other pituitary secretions were normal. Initial tomodensitometry revealed an invasive macroadenoa. The patient had two trans-sphenoidal resections of the tumor completed by radiotherapy [45 Gy]. Afterwards, because of still unsuppressed GH levels, the patient was treated with Octreotide. This first published case of acromegalo-gigantism in Tunisia is particular not only by its rarity but also by its moderated effects on vital functions in spite of along spontaneous evolution
ABSTRACT
We studied the nyctohemeral cortisol secretion rhythm and the cortisol response to 1-24 corticotropin during Ramadan in 11 healthy, male volunteers aged 20-35 years. Their response to 250 mg 1-24 corticotropin was investigated 2 weeks before Ramadan by testing daily at 08:00 and 20:00 hours. After 16-22 days of fasting, their cortisol levels were measured at 08:00 hours and their response to 1-24 corticotropin at 20:00 hours. Before Ramadan, the baseline cortisol level was significantly higher at 08:00 hours than at 20:00 hours and the cortisol response to 1-24 corticotropin was also higher at 08:00 hours but this difference was not significant. During Ramadan, the cortisol level at 08:00 hours was lower than at the same time before Ramadan; the level at 20:00 hours was slightly higher than at the same time before Ramadan. There was no significant difference between the cortisol response to 1-24 corticotropin at 20:00 hours during Ramadan and the responses before Ramadan at 20:00 hours and 08:00 hours