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Honório MLP, Bezerra GH, Costa VLDC. Complete form of pachydermoperiostosis. An Bras Dermatol 2019; 95:98-101. [PMID: 31889594 PMCID: PMC7058884 DOI: 10.1016/j.abd.2019.04.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2018] [Accepted: 04/26/2019] [Indexed: 11/26/2022] Open
Abstract
Pachydermoperiostosis (PDP) or primary hypertrophic osteoarthropathy (PHO) is a rare hereditary disease characterized by digital clubbing, pachydermia, and periostosis. Its pathogenesis is uncertain and the diagnosis is based on clinical and radiological data. A complete form of the syndrome is reported in a male patient with disease onset in adolescence, with compatible clinical and radiological findings, presenting the three cardinal findings as well as other associated manifestations, such as hyperhidrosis and acne.
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Affiliation(s)
- Mônica Larissa Padilha Honório
- Dermatology Service, Hospital Universit´rio Onofre Lopes, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil.
| | - Guilherme Holanda Bezerra
- Dermatology Service, Hospital Universit´rio Onofre Lopes, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
| | - Vivianne Lira da Câmara Costa
- Dermatology Service, Hospital Universit´rio Onofre Lopes, Universidade Federal do Rio Grande do Norte, Natal, RN, Brazil
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Dahlqvist P, Spencer R, Marques P, Dang MN, Glad CAM, Johannsson G, Korbonits M. Pseudoacromegaly: A Differential Diagnostic Problem for Acromegaly With a Genetic Solution. J Endocr Soc 2017; 1:1104-1109. [PMID: 29264563 PMCID: PMC5686617 DOI: 10.1210/js.2017-00164] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 06/23/2017] [Indexed: 11/19/2022] Open
Abstract
Acromegaly is usually not a difficult condition to diagnose once the possibility of this disease has been raised. However, a few conditions present with some aspects of acromegaly or gigantism but without growth hormone (GH) excess. Such cases are described as "pseudoacromegaly" or "acromegaloidism". Here we describe a female patient investigated for GH excess at 10 years of age for tall stature since infancy (height and weight > +3 standard deviations) and typical acromegalic features, including large hands/feet, large jaw, tongue, hoarse deep voice, and headache. Results of radiography of the sella turcica and GH response at an oral glucose tolerance test and insulin–arginine– thyrotrophin–luteinizing hormone–releasing hormone test were normal. Ethinylestradiol and medroxyprogesterone were given for 2 years; this successfully stopped further height increase. Although the patient's growth rate plateaued, coarsening of the facial features and acral enlargement also led to investigations for suspicion of acromegaly at 23 and 36 years of age, both with negative results. On referral at the age of 49 years, she had weight gain, sweating, sleep apnea, headaches, joint pain, and enlarged tongue. Endocrine assessment again showing normal GH axis was followed by genetic testing with a macrocephaly/overgrowth syndrome panel. A denovo mutation in the NSD1 gene (c.6605G>C; p.Cys2202Ser) was demonstrated. Mutations affecting the same cysteine residue have been identified in patients with Sotos syndrome. In summary, Sotos syndrome and other overgrowth syndromes can mimic the clinical manifestations of acromegaly or gigantism. Genetic assessment could be helpful in these cases.
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Affiliation(s)
- Per Dahlqvist
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, and Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg SE-413 45, Sweden.,Department of Public Health and Clinical Medicine, Umeå University, Umeå SE-901 85, Sweden
| | - Rupert Spencer
- Centre for Endocrinology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, United Kingdom
| | - Pedro Marques
- Centre for Endocrinology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, United Kingdom
| | - Mary N Dang
- Centre for Endocrinology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, United Kingdom
| | - Camilla A M Glad
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, and Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg SE-413 45, Sweden
| | - Gudmundur Johannsson
- Department of Internal Medicine and Clinical Nutrition, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, and Department of Endocrinology, Sahlgrenska University Hospital, Gothenburg SE-413 45, Sweden
| | - Márta Korbonits
- Centre for Endocrinology, William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London EC1M 6BQ, United Kingdom
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Abdullah NRA, Jason WLC, Nasruddin AB. Pachydermoperiostosis: a rare mimicker of acromegaly. Endocrinol Diabetes Metab Case Rep 2017; 2017:EDM170029. [PMID: 28567291 PMCID: PMC5445428 DOI: 10.1530/edm-17-0029] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 04/11/2017] [Indexed: 11/23/2022] Open
Abstract
Pachydermoperiostosis is a very rare osteoarthrodermopathic disorder whose clinical and radiographic presentations may mimic those of acromegaly. In the evaluation of patients with acromegaloid appearances, pachydermoperiostosis should be considered as a differential diagnosis. In this article, we report a 17-year-old boy who presented with 2-year history of acral enlargement and facial appearance changes associated with joint pain and excessive sweating. He had been investigated extensively for acromegaly, and the final diagnosis was pachydermoperiostosis.
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Affiliation(s)
| | - Wong Lok Chin Jason
- Department of Medicine, National University of Malaysia Medical Centre, Kuala LumpurMalaysia
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