Microcytic Anemia Revealing Acromegaly

Abstract

Acromegaly is a rare endocrinopathy, related to the hyperfunction of the somatotropic axis. We report through this observation an unusual mode of discovery of acromegaly: microcytic anemia. 38-year-old patient, followed for 1 year for microcytic anemia under iron treatment. On clinical examination, the patient presents an anemic syndrome with a frank dysmorphic syndrome evoking acromegaly. The assessment showed a microcytic anemia at 3.8 g/dl for which he received a transfusion of 09 red blood cells. An IGF1 assay and a hypothalamic-pituitary MRI confirmed the diagnosis of acromegaly secondary to a pituitary macro-adenoma measuring 30x25x18mm. Pituitary Function Testing revealed hypogonadotropic hypogonadism, hyperprolactinemia 5 times normal and thyrotropic deficit. The etiological assessment of the anemia revealed several hemorrhagic gastrointestinal angiodysplasia lesions, probably related to his acromegaly. Acromegaly is a classic cause of colonic polyps, but angiodysplasia lesions have not been described in the literature to our knowledge: is it a digestive tropism of acromegaly that continues to grow? Acromegaly is rarely revealed by anemia, the causal link remains to be established.